I also cannot believe this is the current and appropriate guidance for lobar pneumonia - having been through all the compliance issues that were created by indiscriminate use of the term under ICD-9-CM. The prior compliance issues evolved around coders picking up "lobar" for specificity, oftentimes on the basis of a radiology-generated finding. The interpretation of Lobar Pneumonia at the time - from the medical community perspective - was that this is a term commonly applied to streptococcal pneumoniae. This is significant because this was one of the key issues in all of the Pneumonia Upcoding investigations. Lobar pneumonia implies a bacterial infection and has a complicating presentation. "Lobar" as a location was considered at the time to be a non-essential modifier.
I certainly hope that Coding Clinic provides a subsequent clarification on this if they are absolutely changing the guidance. This is obviously one of the problems with having to balance I-9 Coding Clinic with the ICD-10-CM coding process. Maybe it is time for a different format to get these issues addressed in a more timely fashion - or even put it out there as a "proposed rule" prior to locking it down. I worry about the implications from a clinical validation and RAC investigative process perspective.
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Karen M. Karban, RHIT, CDIP, CCS
Sr. Product Manager
Lumeris
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Original Message:
Sent: 09-28-2018 09:33
From: Nelda Laskey
Subject: Lobar Pneumonia, Coding Clinic Q3, 2018
OH MY GOODNESS!!! Here we go again. After reading 3rd quarter, 2018, read also March-April 1985 and 3rd quarter 2009 Coding Clinics. My question is "who is making these confusing decisions with the Coding Clinic"?
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Nelda Laskey RHIT
Coder/RAC Coordinator
Kearny County Hospital
Original Message:
Sent: 09-27-2018 12:30
From: Teresa Seville
Subject: Lobar Pneumonia, Coding Clinic Q3, 2018
Just wondering what everyone's thoughts are regarding CC advice to code Right Lower Lobe pneumonia to J18.1-Lobar Pneumonia? Thanks.
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Teresa Seville
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