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Ask ACDIS: Denials related to disorders of the brain and sepsis
Q: According to a denial letter, acute metabolic encephalopathy secondary to any disease (which it obviously always is) codes to G94, other disorders of brain in diseases classified elsewhere. The auditor stated to “Please see code category G93.4 which has an excludes 1 note excluding “encephalopathy in disease classified elsewhere” and directs the coder to code G94. Per ICD-10 Official Guidelines...” I appealed this, citing AHA’s Coding Clinic for ICD-10-CM/PCS, Third Quarter 2015, p. 21. While this Coding Clinic does not address this particular metabolic condition, it shows you can code both the metabolic condition and the cause of the condition.
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