Training Plans

Principal Diagnosis Coding


This training plan targets coders who, despite understanding standard coding guidelines, often face difficulties in determining the principal diagnosis. It delves deeply into the intricacies of selecting the principal diagnosis, an area that poses challenges even for those well-versed in coding rules. The plan includes a range of courses, each focusing on different complex aspects of principal diagnosis selection, to provide comprehensive knowledge. These courses are designed to address and clarify common areas of confusion or error in this selection process. Additionally, the plan features practical scenarios where coders can apply their knowledge, testing and refining their skills in identifying the correct principal diagnosis.

Key Takeaways

  • Accurate Selection of Principal/Primary Procedure: Understand the guidelines for correctly identifying the principal or primary procedure in various clinical scenarios.
  • Handling Multiple Procedures: Learn strategies for selecting a principal procedure when multiple procedures are performed but none specifically align with the principal diagnosis.
  • Symptom vs. Diagnosis in Principal Diagnosis Selection: Gain insights on choosing the principal diagnosis when a patient is admitted with a symptom that leads to a different diagnosis.
  • Acute Conditions with Underlying Causes: Master the approach to identifying the principal diagnosis in cases of acute conditions with documented underlying causes.
  • Equal Conditions and Principal Diagnosis (PDX) Selection: Develop skills to determine the appropriate principal diagnosis when two conditions equally apply.
  • Gastrointestinal Bleeding vs. Blood Loss Anemia: Understand the nuances in selecting the principal diagnosis between gastrointestinal bleeding and blood loss anemia.
  • Long Term Acute Hospitals Diagnosis Selection: Learn the criteria for choosing the right principal and secondary diagnoses in Long Term Acute Hospital settings.
  • Principal Diagnosis in Swing Bed Accounts: Acquire knowledge about principal diagnosis selection for Swing Bed accounts.
  • Hospital UB04 Coding Challenges: Explore the complexities in selecting a principal diagnosis in hospital UB04 coding, especially when an equivalent to V57.- code is not available.
  • Differences in Hospital and Rehabilitation Unit Coding: Understand the variances between hospital UB-04 rehabilitation coding and Rehabilitation Unit IRF-PAI diagnosis coding.
  • MS-DRG Impact Awareness: Recognize the impact of principal diagnosis selection on Medicare Severity-Diagnosis Related Groups (MS-DRGs).
  • Outpatient Reporting and CMS Transmittals: Learn about outpatient reporting guidelines and CMS transmittals' implications on diagnosis coding.
  • First Listed Diagnosis in Outpatient Settings: Master the criteria for selecting the "first listed" or "primary" diagnosis in various outpatient encounters.
  • Postoperative Conditions vs. Complications: Differentiate between expected postoperative conditions and true intraoperative or postoperative complications.
  • Quality Measurement Programs Basics: Acquire foundational knowledge about various Quality Measurement programs and their relevance to diagnosis coding.


  • Enhances coding accuracy
  • Clarifies complex diagnoses
  • Improves decision-making skills
  • Updates on latest guidelines
  • Increases professional competency


Why is principal diagnosis coding often considered challenging in medical coding?

Principal diagnosis coding is complex due to the need to interpret varying clinical scenarios, understand the nuances of coding guidelines, and consider the impact of comorbidities and complications. It requires coders to critically analyze medical records and make decisions that accurately reflect the patient's primary reason for the encounter, which can be intricate in cases of multiple diagnoses or symptoms leading to a diagnosis.

How does the selection of the principal diagnosis impact patient care and billing?

The selection of the principal diagnosis is crucial as it drives the medical billing process, affects reimbursement rates, and influences the quality of patient care reporting. Incorrect principal diagnosis coding can lead to billing errors, potential claim denials, and inaccuracies in patient records, which may affect healthcare outcomes and financial performance of healthcare providers.

About our Training Plans

HIAlearn Training Plans are developed to educate the coder in specific coding topics that have proven to be problematic. They are designed to focus on one area in detail, providing the coder with a thorough clinical knowledge of the diagnosis or procedure utilizing videos, photos, and valid websites to aid the coder in fully understanding the topic. Official coding advice and scenarios are utilized to integrate the clinical knowledge provided. Once you complete all the lessons within one course, a 10 question quiz follows. Upon completion, students will have a thorough knowledge of clinical concepts and coding guidelines of the particular topic. Participants have the option to submit their completion certificates to AHIMA, with a selection also available for AAPC CEU(s). Learn more about us »

Cost : $125.99
Courses : 15
Calendar HIAlearn
Access : 60 days
Language : English
Code Type