EmailACS 0001 Principal diagnosis problems and underlying conditions
Publication Date: June 2015
ICD 10 AM Edition: Eighth edition
Retired Date: 30/6/2020
Query Number: 2989
ACS 0001 Principal Diagnosis, sub-heading Problems and underlying conditions, point 2, Coding the problem as the principal diagnosis.
Scenario: patient with previously diagnosed secondary neoplasm to bone, admitted for MANAGEMENT OF BONE PAIN.
We have coders and auditors developing material for students and would appreciate clarification. This has been discussed with more than 20 individuals and the response vary 50/50 between the answers provided so there is clearly a need for clarity.
We are split between coding the bone pain as the PDx (justification that this is the same as Example 3 in the ACS) and coding the cancer as the PDx and not coding the bone pain (justification that this is a symptom of the cancer). Which rule is to be applied as the example implies one option while normal symptom rules imply another.
This issue has occurred many times in different situations - it does not relate to an individual case.
Search Details:
All of the above have been consulted. In addition coding groups in Queensland and NSW have had discussions on the issue but not agreement.
Scenario: patient with previously diagnosed secondary neoplasm to bone, admitted for MANAGEMENT OF BONE PAIN.
We have coders and auditors developing material for students and would appreciate clarification. This has been discussed with more than 20 individuals and the response vary 50/50 between the answers provided so there is clearly a need for clarity.
We are split between coding the bone pain as the PDx (justification that this is the same as Example 3 in the ACS) and coding the cancer as the PDx and not coding the bone pain (justification that this is a symptom of the cancer). Which rule is to be applied as the example implies one option while normal symptom rules imply another.
This issue has occurred many times in different situations - it does not relate to an individual case.
Search Details:
All of the above have been consulted. In addition coding groups in Queensland and NSW have had discussions on the issue but not agreement.
Response
Whilst ACS 0001 Principal diagnosis provides advice for coding the problem as the principal diagnosis, the scenario cited is of a patient previously diagnosed with secondary neoplasm to bone, admitted for management of bone pain. Accordingly, VICC considers that specialty standard ACS 1807 Pain diagnoses and pain management procedures applies to this scenario.
ACS 1807 states that when pain is directly associated with another condition, assign only the code(s) for the condition(s) causing the pain. Therefore the correct principal diagnosis in this scenario is C79.5 Secondary malignant neoplasm of bone and bone marrow.
ACS 1807 states that when pain is directly associated with another condition, assign only the code(s) for the condition(s) causing the pain. Therefore the correct principal diagnosis in this scenario is C79.5 Secondary malignant neoplasm of bone and bone marrow.
