Tricky Coding Rules
Principal Diagnosis for a pregnant 30 year old who comes in with Covid pneumonia/Acute resp failure and is intubated in the EC. Three days later her baby is emergently delivered via c-section.
What is Diseases of the resp system complicating childbirth…ie: the c-section code?
This doctor loves “severe protein calorie malnutrition”
Who is Dr. Brooks?
This is what PPC stands for.
What is Potentially Preventable Complication or Provider Preventable Complication?
Term for a pre-existing condition which will increase the LOS by at least 1 day in 75% of cases.
What is comorbidity?
Which one is the real ICD 10 Code:
*2nd degree burn by lava
*Flatulence causing injury
*Rash from eating steak
What is Flatulence causing injury?
Principal diagnosis for a well controlled diabetic patient who presents with gangrenous foot and osteomyelitis.
What is Diabetes with peripheral angiopathy with gangrene?
Despite a good query response rate, fairly consistently has the lowest “agree” rate
Who is Dr. Pirtle?
This is what PSI stands for.
What is Patient Safety Indicators?
Term for condition arising during the hospital stay that will increase the LOS by at least 1 day in 75% of cases.
What is a complication?
Which one is the real ICD 10 Code:
*Burn due to water-skis on fire, initial encounter
*Laughter causing injury
*Fall from stage at an opera house
What is Burn due to water-skis on fire, initial encounter?
Patient has huge necrotic wound and possible osteomyelitis. Surgeon incises the skin and debrides down 10cm clearing out all necrotic material. For your procedure code, this is the Depth of debridement.
What is the skin?
Provider group that struggles to get the ABLA thing right
Who is orthopedics?
This is what HAC stands for.
What is Healthcare Acquired Conditions or Hospital Acquired Conditions?
This is what EBM stands for
What is evidenced based medicine?
Which one is the real ICD 10 Code:
*Dragged while fixing wheel chair
*Crushed by an ambulance, initial encounter
*Bizarre personal appearance
What is Bizarre personal appearance?
Principal diagnosis for your patient who presents with toxic encephalopathy secondary to taking more oxycontin than prescribed.
What is Poisoning due to opioids?
Provider who responded: “Chill, These are not emergency.., STOP bugging please”
Who is Dr. Saleem?
This one is a Medicaid penalty.
What is a PPC?
This agency oversees the National Patient Safety Goals
What is The Joint Commission?
Which one is the real ICD 10 Code:
*Asphyxiation due to being trapped in a refrigerator, accidental, subsequent encounter
*Limb compressed by conveyor belt
*Pierced by a Middle Eastern sword, initial encounter
What is Asphyxiation due to being trapped in a refrigerator, accidental, subsequent encounter?
The principal diagnosis for your patient who presents next month with Severe Sepsis and Hemolytic uremic syndrome due to the sepsis.
What is Infection associated hemolytic uremic syndrome?
Provider who responded: “This is one of the stupidest inquiries I have seen. If all these numbers you listed in your inquiry are documented in the chart, why do you need to say anything else?"
Who is Dr. Linton?
This company owns the logic/methodology used for PPCs.
What is 3M?
This was the year MS-DRGs were launched
When is 2007?
Which one is the real ICD 10 Code:
*Crushed by bricks while impersonating a test dummy
*Fall onto a pile of rusty nails, subsequent encounter
*Sibling Rivalry
What is Sibling Rivalry?