RE: coding

Hello everyone
Can J811 be used as primary DX? Grace Alayon MSNEd, FNP-C, ARNP/AdmTendra Home Health, Inc.3157 East 4th Ave Hialeah, FL 330138569 Pines BLVD Suite 209 Pembroke Pines, FL  33024Phone 305 696-2323 Fax 305 696-2304Email: tendra_services@yahoo.com This communication including any attachments, may contain confidential information and is intended only for the individual or entity to whom it is addressed. Any review, dissemination, or copying of this communication by anyone other than the intended recipient is strictly prohibited. If you are not the intended recipient, please contact the sender via email, delete and destroy all copies of the original message. 

Comments

  • J81.1 Chronic pulmonary edema, or pulmonary congestion (chronic) has no restriction as far as coding primary vs secondary.
    However, this is a code that is more appropriately used with a pulmonary/cardiac work-up to establish the underlying pathology or diagnosis.
    Pulmonary congestion is integral to several underlying conditions such as CHF and pneumonia. Coding conventions are one does not use a symptom code when it is an integral part of a known condition. If the underlying condition is not known, then the symptom is coded, and one should assume the person with this type of “symptom” is undergoing a complete work-up by the physician in order to best approach treatment. Of course none is done without physician documentation.

    Nancy Wolverton RN,CCM
    QR Specialist, Central Office
    5800 West 10th St., Suite 300
    Little Rock, AR. 72205
    Ph# 501-280-4913
    Fax# 501-280-4385
    Nancy.Wolverton@arkansas.gov
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