APR DRG of the Week: APR-DRG 722: Fever

Change the Principal diagnosis

• Alternate principal diagnoses recommended by FairCode docs include ...
  • 522.5     Periapical abscess                                            →  DRG 114
  • 466.11   RSV infection                                                  →  DRG 138
  • 486        Pneumonia                                                       →  DRG 139
  • 999.31   Infection due to central venous catheter          →  DRG 206
  • 575.11   Chronic cholecystitis                                        →  DRG 284
  • 577.1     Chronic pancreatitis                                         →  DRG 282
  • 725        Polymyalgia rheumatica                                  →  DRG 460
  • 584.9     Acute renal failure                                            →  DRG 140
  • 202.10   Non-hodkins lymphoma                                   →  DRG 691
  • 038.9     Septicemia                                                         →  DRG 720
  • 998.59   Postoperative infection                                      →  DRG 721

Add a Secondary Diagnosis

• Respiratory disorders: 780.57 Sleep apnea, 496 COPD, 486 Pneumonia
• Gastrointestinal disorders: 070.70 Hepatitis C
• Electrolyte disorders: 276.1 Hyponatremia, 276.8 Hypokalemia, 276.2 Acidosis
• Cardiovascular disorders: 428.0 Congestive heart failure, 416.8 Pulmonary hypertension,
• Renal disorders: 788.30 Urinary incontinence, 584.9 Acute renal failure
• Other: 348.30 Encephalopathy, V07.0 Need for isolation, 599.0 UTI, 268.9 Vitamin D deficiency, 278.01 Morbid obesity V85.4 BMI over 40, 799.4 Cachexia

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Discussion

• Since fever is a symptom, it should not be coded as Principal when a related definitive diagnosis is known. List fever as principal when the cause is not determined or when it is followed by two or more contrasting/comparative diagnoses. (CC 4^th Q 2009)