AHA Coding Clinic® for ICD-9 - 2013 Issue 4; Ask the Editor
Administration of tPA for Stroke Treatment Before Transfer
A patient was transferred to our facility due to a likely stroke. Prior to her transfer, tissue plasminogen activator (tPA) was administered at the transferring hospital (Hospital A). We have been advised that the tPA administration should not be reported at the receiving facility (Hospital B). However, the infusion of tPA is still ongoing, during the transport, as well as when the patient arrives at our facility. Is it appropriate to assign the ICD-9-CM procedure code 99.10 when the tPA is not started at our facility? ...
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Article Overview
This premium coding article discusses a stroke-related transfer scenario in which thrombolytic therapy was initiated at one facility and continued during transport to another. It is relevant to hospital coders, inpatient coding staff, and compliance teams who need to understand how the situation is discussed in coding guidance and how procedure and diagnosis reporting considerations are framed for the receiving facility.
Why This Topic Matters
Transferred patients can create uncertainty about whether a receiving hospital should report therapy that began elsewhere and is still in progress on arrival. The article helps coders interpret the documentation and avoid misapplication of procedure reporting in a transfer setting.
What You Will Learn
- How a transfer scenario involving thrombolytic therapy is presented in coding guidance
- What kinds of procedure-reporting questions arise when treatment begins at a referring hospital
- How the article frames diagnosis coding considerations in the context of a stroke transfer case
- Why continuing therapy during transport can affect reporting at the receiving facility
Who Should Read This
- Hospital coders
- Inpatient coding staff
- Coding compliance professionals
- Health information management staff
Codes Discussed
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