Combination Code Support by CDI

As we continue our journey towards ICD-10 implementation on October 1, 2015, the use of combination codes brought up a discussion between myself and another CDS (Clinical Documentation Specialists). I had just read this article, and we were doing some chart review and code capture in ICD-10, when we saw the combo code that was our principal diagnosis as well as our MCC driving the DRG. It was at this point that I was reminded of the importance of linking in the work of Clinical Documentation Integrity. We are asked to query in ICD-10 for more specificity as well as the linkage of diagnoses such as heart disease and kidney disease. Working through the ICD-10 decision tree and capturing the most accurate combination code is essential for accurate, compliant coding. The outcome of a principal diagnosis and a co-morbid condition (whether Major CC or a CC with the one code) to me shows that the code set has taken into account the most accurate codes and the severity of the conditions individually captured within that code. I am starting to get excited about the fall, not only because it is one of the most beautiful times here in the Midwest, but also because of the implementation of ICD-10 and the potential outcomes that it will drive in improved patient care.

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