Coding, Classification & Reimbursement

Coding pulnonary embolism

  • 1.  Coding pulnonary embolism

    Posted 01-02-2019 21:52
    Patient had PE 6 weeks ago. Embolectomy was done, and xarelto was given and patient is still on it. Pt admitted now for unrelated condition. Chest x-ray was clear, C02 and O2 were normal. D dimer not done.
    CDI wants coders to add "acute pulmonary embolism" since pt is still on anticoagulant. Since there is no longer any evidence of the embolus, should the acute PE be coded?

    Julie Treppish
    Coding Lead

  • 2.  RE: Coding pulnonary embolism

    Posted 01-03-2019 11:53
    I would code personal hx of PE and long term use of anticoagulants.   Any other suggestions?  Happy New Year to all.

    Nelda Laskey RHIT
    Coder/RAC Coordinator
    Kearny County Hospital

  • 3.  RE: Coding pulnonary embolism

    Posted 01-03-2019 13:01
    ​I would also code history of pulmonary embolism and long term use of anticoagulants.  The embolism is no longer current and the patient is on anticoagulants to prevent another embolism.

    Heather Swanson
    Revenue Integrity Audit Specialist

  • 4.  RE: Coding pulnonary embolism

    Posted 01-04-2019 09:10
    I would query the provider whether the long-term anti-coagulation therapy is therapeutic or for prophylaxis  See related Coding Clinic's..
    If, therapeutic, I would code the PE as active.

    Laura C Jones, RHIT, CCS
    ICD-10-CM/PCS Validator

  • 5.  RE: Coding pulnonary embolism

    Posted 01-08-2019 04:07
    Hi Julie,

    For the above case in my opinion, We need to code as Hx of PE followed by Long term use of anticoagulant. When a patient is suffered from PE, he will be treated aggressively with  anticoagulant at the time of admission itself. Later on Pt will be kept on antiocoagulant such as xarelto for the prophylactic purpose.

    Please cross check with your record whether he is treating prophylactically or therapeutically. If you are still unclear, please query to the physician  whether PE is still present in the patient or it was already resolved.

    Hope this will helps you. Have a great day..

    Naresh Dhodle CCS,CIC,COC,LSSGB
    Quality Team Lead

    Naresh Dhodle