October 2023 PKT Part-1 | Appeals Team

Full Name (Last Name, First Name)

Employee ID

MSID

​ Supervisor​

• Meah Chloe Siena

• Sarah Villaverde

Chartpoint Initial (3-character initials)

A newborn record and the facility has assigned secondary diagnosis code P09.6 Abnormal findings on neonatal screening for neonatal hearing loss.  The documentation supports that the newborn did fail their hearing screening and the discharge instructions include a follow up appointment with a pediatric audiologist.

Is it appropriate to code P09.6, Abnormal findings on neonatal screening for neonatal hearing loss?

• Yes, appropriate to code as a diagnosis.

• No, a condition was not diagnosed.

The patient presented to the emergency room at hospital A with abdominal pain, nausea and vomiting along with hematemesis. Documentation noted that the patient required evaluation by a GI specialist which was not available at hospital A. The decision was made to transfer the patient to hospital B. Prior to the transfer he developed respiratory distress and required emergent intubation. He was transferred to hospital B and admitted to the ICU. The critical care physician at hospital B listed the principal problem as acute hypoxic respiratory failure. Hospital B assigned a principal diagnosis of K92.0 Hematemesis. What is the appropriate Principal Diagnosis?

• J96.01, Acute respiratory failure with hypoxia

• K92.0, Hematemesis

ICD-10 CM Guidelines: Indicate the appropriate POA on the following conditions: 

I25.2, (Old Myocardial Infarction)

• POA-Y

• POA-N

• POA-U

• POA-W

• Exempt from POA reporting

ICD-10 CM Guidelines: Indicate the appropriate POA on the following conditions: 

T81.72XA, (Postoperative pulmonary embolism) during inpatient stay

• POA-Y

• POA-N

• POA-U

• POA-W

• Exempt from POA reporting

ICD-10 CM Guidelines: Indicate the appropriate POA on the following conditions: 

Q21.1, (Atrial septal defect)

• POA-Y

• POA-N

• POA-U

• POA-W

• Exempt from POA reporting