This issue of In The Know is a continuation of Coding Clinic Advice provided for the 4th quarter of 2017.


Coding "Ruled Out" Diagnosis

The question was asked, "Should diagnoses that are ruled out at the time of discharge, but were considered during the hospital stay be coded?" Advice provided stated that even if the condition has been worked up and initially treated, once the condition is "ruled-out", it should no longer be coded.

Coding Clinic, 4th Qtr 2017, pg 102


Graft Replacement

Value "R" for Replacement - has been added as a Root Operation to the following 5 new tables for the capture of more specific detail for reconstructive procedures using graft material. Table 00R (Central Nervous and Cranial Nerves), 01R (Peripheral Nervous), 0BR (Respiratory), 0KR (Muscles), and 0MR (Bursae and Ligaments).

Coding Clinic, 4th Qtr 2017, pg 41


Magnetic Growth Rods

Magnetic growth rods, usually along with fusion, are used as treatment for pediatric scoliosis. This treatment is usually done through an open or percutaneous approach. Code table XNS has had approach value 3 added to account for this procedure. Replacement or Revision, for both magnetic and conventional of growth rods, may be necessary. Fusion will need to be coded separately if performed.

Coding Clinic, 4th Qtr 2017, pgs 74-75