Coding Tip: How to code Clostridium Difficile Enterocolitis (C.diff)

Clostridium Difficile Enterocolitis (C. diff) is a diagnosis that coders see a lot these days. This is a bacteria that causes inflammation in the large intestine (colitis) and may cause watery diarrhea, fever, nausea and abdominal pain. C. diff causes antibiotic-associated colitis by colonizing the intestine after the normal gut flora is altered by the use of antibiotic therapy. The bacteria is most often found in older patients or those that require prolonged use of antibiotics.

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Coding Tip: COPD and Pneumonia Sequencing FY 2018

How does a coder sequence COPD and pneumonia? As of October 1, 2017 the note under the code J44.0 COPD (chronic obstructive pulmonary disease, with acute lower respiratory infection) was changed from “Use additional code to identify infection” to “Code also to identify the infection”. A “code also” note does NOT give a sequencing directive as the “use additional code” does. The PDX should be assigned based on the circumstances of the admission. Below are some examples that may help you determine the PDX when COPD and pneumonia are both present and responsible for the admission.

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