tci General Surgery Coding Alert - 2023 Issue Q3

Reader Questions: Code Final Dx First

Question: Our surgeon performed an exploratory EGD for a patient with persistent abdominal pain, nausea, vomiting, and diarrhea. Following the procedure, the surgeon diagnosed the patient with unspecified infectious gastroenteritis. I submitted the symptoms in order of severity, so the nausea with vomiting was first, followed by the diarrhea, then the abdominal pain, then the gastroenteritis. The claim was denied. Why? Georgia Subscriber Answer: Improper ICD-10-CM code sequencing probably caused the denial. According to the ICD-10-CM Official Guidelines, the principal diagnosis should be sequenced first. The patient presented with a series of symptoms, but the provider determined the cause...

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