Principal Diagnosis Selection: Acute vs Chronic or Underlying Conditions
Description
In this course, participants will delve into the complexities of selecting the principal diagnosis for inpatient stays, a critical task that drives reimbursement and resource allocation. The course focuses on scenarios where patients present with acute conditions stemming from documented underlying causes, often chronic in nature. Through in-depth analysis and real-world examples, students will navigate the intricacies of coding guidelines, official conventions, and chapter-specific rules to make informed decisions on whether to code the acute or underlying condition as the principal diagnosis.
Included Lessons:
- Introduction
- ICD-10-CM Official Guidelines for Coding and Reporting
- Additional Information
- Coding Clinics Pertaining to Sequencing of Acute Condition or Underlying Cause
CEUs available for the following credentials:
AHIMA
CCA, CCS, CCS-P, RHIT, RHIA, CDIP, CHDA, CHPS
Key Takeaways
This course equips medical coders with the knowledge and skills needed to make informed and accurate decisions when selecting the principal diagnosis in complex and challenging medical cases. Some key takeaways of this course include:
- Understanding of Principal Diagnosis Selection: Coders will gain a deep understanding of the importance of selecting the correct principal diagnosis and how it influences the MS-DRG or APR DRG, impacting reimbursement and resource allocation.
- Differentiating Acute and Chronic Conditions: Participants will learn to distinguish between acute conditions and chronic or underlying causes, even in complex clinical scenarios.
- Navigating Official Guidelines: Coders will become proficient in navigating the ICD-10-CM Official Guidelines for Coding and Reporting, including conventions, general guidelines, and chapter-specific guidelines.
- Symptoms vs. Diagnoses: Coders will learn when to code symptoms separately and when to code them as part of the principal diagnosis, particularly in cases where a definitive diagnosis has not been established.
- Integral vs. Non-Integral Conditions: Participants will grasp the concept of integral conditions that are routinely associated with a disease process and learn not to code them separately, as opposed to non-integral conditions that should be coded when present.
- Coding in Specific Medical Situations: Coders will gain practical knowledge of how to code in specific medical situations, such as when a patient presents with both acute and chronic conditions and when to code the acute condition as the principal diagnosis.
- Utilizing ICD-10-CM Index and Tabular: Participants will learn to effectively use the ICD-10-CM Index and Tabular to find coding guidance, especially when the coding scenario lacks clear instructions.
Benefits of Taking this Course
- Increased Coding Accuracy
- Improved Skills in Differentiating Acute and Chronic Conditions
- Greater Confidence
- Professional Growth
- Streamlined Coding Processes
FAQs
What is the significance of selecting the correct principal diagnosis in medical coding?
Selecting the correct principal diagnosis is crucial in medical coding because it drives the assignment of MS-DRG or APR DRG, which directly impacts reimbursement and resource allocation for healthcare facilities. It ensures that the primary reason for a patient's admission is accurately reflected in the medical record.
When should I code a symptom separately, and when should I include it as part of the principal diagnosis?
About our Medical Coding Courses
HIAlearn, powered by Health Information Associates (HIA)—a leader in medical coding and auditing for more than three decades—offers a comprehensive online education platform for medical coders. With a catalog of over 200 medical coding courses accepted by the American Health Information Management Association (AHIMA) for Continuing Education Units (CEUs) and a selection approved by the American Academy of Professional Coders (AAPC), HIAlearn caters to both beginners and experienced medical coders seeking to enhance their skills. The platform provides an array of training plans tailored to meet individual learning needs, from mastering challenging coding procedures to understanding broad conceptual frameworks within the coding world. Courses are available across various coding types including CPT, E/M, ICD-10-CM, ICD-10-PCS, and are designed to cater to different coder levels and coding specialties such as inpatient, outpatient, profee, and CDI. Additionally, HIAlearn offers a Coding Updates bundle to ensure coders are up-to-date with the annual changes in ICD-10-CM, ICD-10-PCS, CPT, and IPPS. Beyond individual learning, HIAlearn supports organizations with group discounts, promoting enhanced coding accuracy, efficiency, and compliance across teams.
Disclaimer: This course is not available for individual sale. Purchase the Principal Diagnosis Training Plan below and get access to 15 total courses.
Overview
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