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Consistent w/Diagnosis codes

Jamie Posted Wed 27th of March, 2019 15:23:25 PM
We need further clarification on if we are able to code diagnosis codes where the provider states its "consistent with" .....For Example: Provider diagnosed a patient w/ Livedo reticularis (R23.1) but also stated "Appearance of rash consistent with livedo reticularis" It is my understanding that "Consistent with" falls under the same category as suspected, probable, questionable, or anything else along those lines that does not indicate certainty and can not be used as a dx code and needs to be coded towards signs/symptoms. Can you please clarify the rule/guideline? Thank you
SuperCoder Answered Thu 28th of March, 2019 08:49:23 AM

Hi Jamie,

 

Thanks for your question.

 

The words "consistent with" do not give a definitive diagnosis, which means you should not assume the patient has the condition that the results are "consistent with." "Consistent with" and "compatible with" situations should be considered as "probable," "possible" and "likely" diagnoses. So, do not code conditions that are referred to as 'consistent with'.

 

Instead, if a definitive diagnosis has not yet been determined, you should report diagnosis codes for the symptoms that the patient presents with.

 

Please feel free to write if you have any question.

 

Thanks

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