AHA Coding Clinic 1st Quarter 2018 – Key Highlights

Coding Clinic 1st Quarter 2018 (effective with discharges starting February 18) unsurprisingly did not include any significant changes since the previous Coding Clinic release was more extensive. It is a good sign that many of the controversial and pressing issues like COPD with pneumonia sequencing has been addressed and now we are now left with coding guidance for Adult Dandruff (Pityriasis Capitis Simplex).

Below are a few highlights from the latest release:

Uncertain Diagnosis “Concern for”

  • Coding Clinic has confirmed that documentation of “concern for” should be treated as an acceptable “uncertain diagnosis” which, in the inpatient setting can be coded if the diagnosis is documented as such at the time of discharge
  • In addition to “”probable,” “suspected,” “likely,” “questionable,” “possible,” or “still to be ruled out,” coders can now accept “concern for”
  • For example, if the attending documents on the discharge summary: “CT chest was concerning for pneumonia”, it should be captured as a final diagnosis

Chronic Viral Hepatitis C, Liver Cirrhosis and Ascites

  • For ascites due to liver cirrhosis and chronic viral hepatitis C assign B18.2, chronic viral hepatitis C, K74.60, unspecified cirrhosis of liver, and R18.8, other ascites
  • Do not assign K71.51, toxic liver disease with chronic active hepatitis with ascites even though the Index directs coders there
  • This is another example of when coders are supposed to apply the rule that, “if the code indexed does not identify the condition correctly, then further research/review may be required”

Resection of Lymph Node Chains

  • The root operation “Resection” is coded when one or more entire chains of lymph nodes is cut out
  • When one or more entire chains of lymph nodes plus one or more partial chains of lymph nodes or isolated lymph nodes are cut out only assign a code for Resection
  • Do not assign an additional Excision code for the isolated lymph nodes

Repair of Internal Hernia at Petersen Space

  • For repair of internal hernia at Petersen space assign, 0DQV4ZZ, repair mesentery, percutaneous endoscopic approach, for laparoscopic repair of the internal hernia in Petersen space
  • The opening between the mesentery of the alimentary loop and the mesocolon of the colon transversum is called Petersen space


  1. AHA Coding Clinic – 1st Quarter 2018

Recent Insights

Newsletter Sign-Up