Q&A: Do complication codes take precedence over other condition codes?
Q: When I started CDI, I was told that when a complication code happens to be the reason of admission, along with another condition also contributing to the admission, the complication code takes precedence over the other condition code. Is this correct, and is there any written evidence, like a Coding Clinic that tells me to do so?
A: The code set offers us direction within the alphabetic index and tabular list related to sequencing with notes that instruct us to code first, or code also, for example. There is instruction within the Official Guidelines for Coding and Reporting as to how to interpret the directional notes, found in Section I. The coding conventions is often the first place I check.
And, of course, the AHA Coding Clinic also gives us guidance. There is a hierarchy of what piece of guidance supersedes the other. The instructions within the index and tabular list (coding conventions) is the highest, followed by the Official Guidelines of Coding and Reporting, and, last, the AHA Coding Clinic.
In the Official Guidelines of Coding and Reporting Section II: Selection of Principal Diagnosis, Section G states:
“Complications of surgery and other medical care when the admission is for treatment of a complication resulting from surgery or other medical care, the complication code is sequenced as the principal diagnosis. If the complication is classified to the T80-T88 series and the code lacks the necessary specificity in describing the complication, an additional code for the specific complication should be assigned.”
Thus, your understanding of how these should be sequenced is absolutely correct and now you are able to state where you accessed this instruction.
Editor’s Note: Laurie L. Prescott, RN, MSN, CCDS, CDIP, CRC, CDI Education Specialist at HCPro in Danvers, Massachusetts, answered this question. Contact her at lprescott@hcpro.com. For information regarding CDI Boot Camps visit www.hcprobootcamps.com/courses/10040/overview.