APR DRG of the Week: APR-DRG 111: Vertigo & Other Labyrinth Disorders

Oct 13 2011 3:41 PM

Change the Principal diagnosis

Alternate principal diagnoses recommended by FairCode docs include ...
- 486 Pneumonia → DRG 139
- 383.00 Mastoiditis → DRG 113
- 491.21 COPD Exacerbation → DRG 140
- 780.2 Syncope → DRG 204
- 429.X Cardiac complication → DRG 206
- 458.21 Hypotension from Hemodialysis → DRG 207
- 578.9 Gastrointestinal bleed → DRG 253
- 340 MS exacerbation → DRG 43
- 458.9 Acute renal failure → DRG 460
- 453.9 Transient Ischemic Attack → DRG 47
- 250.6X Diabetes with neurologic manifestations → DRG 48
- 346.90 Migraine headache → DRG 54

Add a Secondary Diagnosis

Electrolyte disorders: 276.1 Hyponatremia, 276.8 Hypokalemia

Cardiovascular disorders: 411.1 Unstable angina, 428.0 Congestive heart failure, 458.9 Hypotension, 397.0 Tricuspid regurgitation, 427.1 Ventricular tachycardia, 416.8 Pulmonary hypertension

Respiratory disorders: 496 COPD, 511.9 Pleural effusion

Endocrine disorders: 250.02 Diabetes, uncontrolled, 250.6X Diabetes with neurologic manifestions, 278.01 Morbid obesity V85.4 BMI over 40, 277.7 Dysmetabolic syndrome

Renal disorders: 788.20 Urinary retention, 584.9 Acute renal failure

Neurologic disorders: 331.4 Cerebral atrophy, 437.1 Cerebral ischemia, 342.9X Hemiparesis, 433.10 Carotid artery stenosis

Other: V498.3 Awaiting Organ transplant Hematologic disorders: 287.5 Thrombocytopenia

Discussion

Coding rules dictate that symptom codes should not be listed as the principal diagnosis when a related condition is present (Coding Clinic 2nd Q 1990 page 3). Patients may experience dysequilibrium as a result of many underlying conditions, including the examples above. Look for documented diagnoses that explain the patient's dysequilibrium and can provide a principal diagnosis that is more specific than the general symptom of dysequilibrium