What is the definition of principal procedure?
The principal procedure is one that is performed for definitive treatment rather than one performed for diagnostic or exploratory purposes, or was necessary to take care of a complication.
What does principal diagnosis mean?
the condition, after study
The principal diagnosis is defined as “the condition, after study, which caused the admission to the hospital,” according to the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2016. This is not necessarily what brought the patient to the emergency room.
What is the principle procedure code?
PRINCIPAL PROCEDURE PERFORMED FOR DEFINITIVE TREATMENT (RATHER THAN DIAGNOSTIC OR EXPLORATORY PURPOSES). IT IS RELATED TO EITHER THE DIAGNOSIS OR TO COMPLICATIONS.
How does a coder determine the principal procedure if two procedures appear to be the principal?
- if 2 procedures equally meet the definition, the principal procedure is the one most related to the principal diagnosis.
- if 2 procedures are equally related to the principal diagnosis, the most resource-intensive or complex procedure is usually designated as principal procedure.
What is a principal procedure provide an example?
What is the principal procedure? The procedure that is performed for definitive treatment or is taking care of a complication is the principal procedure. In this case, the coronary artery bypass is the principal procedure as it is being performed for definitive treatment of the heart disease.
What is principal procedure date?
SRGCL_PRCDR_PRFRM_1_DT. The date on which the surgical procedure was performed during the beneficiary’s stay.
What is the definition of principal procedure quizlet?
The principal procedure is. one performed for definitive treatment (rather than for diagnostic or exploratory purposes) or one that is necessary to care for a complication.
Which of these is a true characteristic of significant procedures?
It is always necessary to start with the Alphabetic Index before proceeding to the Tables to complete a code. A significant procedure is one that is: surgical in nature; carries an anesthetic risk; carries a procedural risk and requires specialized training.
What are 4 criteria for a significant procedure?
2. In accordance with UHDDS definitions, all significant procedures are to be reported. A significant procedure is one that: (1) is surgical in nature, or (2) carries a procedural risk, or (3) carries an anesthetic risk, or (4) requires specialized training.
What procedure is performed for definitive treatment of the principal diagnosis?
Instruction: The procedure that is performed for definitive treatment most related to the principal diagnosis should be sequenced as the principal procedure. 3.
What establishes medical necessity for procedures?
In a fee-for-service world, physician claims are paid on the basis of fees associated with the CPT or Healthcare Common Procedure Coding System (HCPCS) code submitted on the claim form. The diagnosis code establishes the medical necessity for the service. The claim form submitted to the insurance company tells a story.
When two or more diagnoses equally meet the definition for the principal diagnosis?
In the unusual instance when two or more diagnoses equally meet the criteria for principal diagnosis as determined by the circumstances of admission, diagnostic workup and/or therapy provided, and the Alphabetic Index, Tabular List, or another coding guidelines does not provide sequencing direction, any one of the …
What is the principal procedure in medical terms?
What is the principal procedure? The procedure that is performed for definitive treatment or is taking care of a complication is the principal procedure. Procedures for diagnostic or exploratory purposes that are performed in addition to a procedure being performed for definitive treatment, would be reported in addition to the principal procedure.
What are the instructions for the selection of principal procedure?
The following instructions should be applied in the selection of principal procedure and clarification on the importance of the relation to the principal diagnosis when more than one procedure is performed: Procedure performed for definitive treatment of both principal diagnosis and secondary diagnosis
Which procedure is most related to the principal diagnosis?
Sequence diagnostic procedure as principal procedure, since the procedure most related to the principal diagnosis takes precedence. No procedures performed that are related to principal diagnosis; procedures performed for definitive treatment and diagnostic procedures were performed for secondary diagnosis a.
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