Reference no: EM133387143

 Assignment:

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When coding procedures, the classification is arranged differently than coding for diagnosis. These procedures are coded from the body part, and by root operations that are carried out on that body part.

The chart for a patient receiving a coronary artery bypass of the left ascending coronary artery and the obtuse marginal coronary artery would be coded to guideline B3.6b which states: "Coronary artery bypass procedures are coded differently than other bypass procedures as described in the previous guideline. Rather than identifying the body part bypassed from, the body part identifies the number of coronary arteries bypassed to, and the qualifier specifies the vessel bypassed from."

Selection of the principal procedure depends very much on the principal diagnosis. The guidelines state repeatedly that the procedure most related to the definitive treatment of the principal diagnosis should be sequenced first, regardless of whether the procedure was diagnostic in nature or not. The procedure that was carried out that most definitively treated the principal diagnosis should be selected as the principal procedure.

For the patient admitted with acute appendicitis, who was taken to surgery for an appendectomy and was also given a colonoscopy, the principal procedure would be the appendicitis. This is because the admitting diagnosis - the diagnosis that, after study, occasioned the patient's admission to the hospital - was appendicitis, and the definitive treatment for acute appendicitis is appendectomy and not colonoscopy.