No.  Coding should not be using a differential diagnosis.  It depends on how it 
is worded.  “Probable”, for example, will get coded.  “Possible” will not.  I 
have ED docs who will put everything but the kitchen sink into the differential 
because they think that will justify a higher level of billing.  They 
frequently have a template with a huge list of differentials.  And it does not 
meet criteria for source of infection.

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I would like to understand how my peers are abstracting a particular issue. I 
have a question for the group…
 
If you have a patient in the EC and the physician lists as part of the 
differential diagnoses a UTI or PNA. Then the physician documents as his final 
EC diagnosis respiratory failure, COPD with exacerbation. Then let’s say the 
patient does have the clinical signs to support severe sepsis. (temp 102, Pulse 
124, Respiratory failure documented and placed on vent).
 
Do you count the differential diagnoses of UTI and PNA as a source of infection 
in this scenario?
 
Thanks,
Debra
 
Debra M. Cox, BSN, RN
STTI Member
Corporate Quality Specialist | Quality Services
 

 
101 East Wood Street | Spartanburg, SC 29303
O: 864-560-2694 | c: 864-327-5731 | f: 864-560-7365
e: [email protected] <mailto:[email protected]>| w: SpartanburgRegional.com 
<http://www.spartanburgregional.com/>
 
"You never change things by fighting the existing reality. To change something, 
build a new model that makes the existing model obsolete."         ~R. 
Buckminster Fuller

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