Ref No: Q2694 | Published On: 15-Mar-2015 | Status: Current SUBJECT: Total parenteral nutrition (TPN) For New Zealand the advice for TPN is effective for events with an event date on or after 1 July 2015 Q: Should total parenteral nutrition be coded? A: Total parenteral nutrition (TPN) is the administration of nutrients to a patient usually via a central venous catheter and is usually a short term treatment, although in some conditions has been used as a long term therapy. TPN is classified in ACHI under Pharmacotherapy and the guidelines in ACS 0042 Procedures not normally coded, point 8 should be followed: 8. Drug treatment/pharmacotherapy Drug treatment should not be coded except if: the substance is given as the principal treatment in same-day episodes of care drug treatment is specifically addressed in a coding standard (see ACS 0044 Chemotherapy, ACS 1316 Cement spacer/beads and ACS 1615 Specific interventions for the sick neonate). (Coding Rules, March 2015) Ref No: Q2820 | Published On: 15-Mar-2015 | Status: Current SUBJECT: Cellulitis of an infected blister Q: Patient admitted for cellulitis of an infected blister of the index finger. Swabs taken of the blister grew Staphylococcus aureus which clinical documentation confirmed as the source of the infection. Should a code for cellulitis be assigned as well as T79.3 Post traumatic wound infection, not elsewhere classified, as per ACS 1916 Superficial injuries? A: ACS 1916 Superficial injuries instructs that T79.3 Post traumatic wound infection, not elsewhere classified and a code for the associated infectious agent should be assigned as additional codes if a superficial injury is infected. The instruction in the specialty standard should be followed despite T79.3 being an NEC code. However it does not preclude the assignment of a more specific code for the infection, such as cellulitis in the scenario cited. For example: Patient admitted for cellulitis of an infected blister of the index finger. Documentation in the clinical record confirms an associated infection with Staphylococcus aureus. The following codes would be assigned (and sequenced following the principles in ACS 0001 Principal diagnosis):
Ref No: Q2694 | Published On: 15-Mar-2015 | Status: Current SUBJECT: Total parenteral nutrition (TPN) For New Zealand the advice for TPN is effective for events with an event date on or after 1 July 2015 Q: Should total parenteral nutrition be coded? A: Total parenteral nutrition (TPN) is the administration of nutrients to a patient usually via a central venous catheter and is usually a short term treatment, although in some conditions has been used as a long term therapy. TPN is classified in ACHI under Pharmacotherapy and the guidelines in ACS 0042 Procedures not normally coded, point 8 should be followed: 8. Drug treatment/pharmacotherapy Drug treatment should not be coded except if: the substance is given as the principal treatment in same-day episodes of care drug treatment is specifically addressed in a coding standard (see ACS 0044 Chemotherapy, ACS 1316 Cement spacer/beads and ACS 1615 Specific interventions for the sick neonate). (Coding Rules, March 2015) Ref No: Q2820 | Published On: 15-Mar-2015 | Status: Current SUBJECT: Cellulitis of an infected blister Q: Patient admitted for cellulitis of an infected blister of the index finger. Swabs taken of the blister grew Staphylococcus aureus which clinical documentation confirmed as the source of the infection. Should a code for cellulitis be assigned as well as T79.3 Post traumatic wound infection, not elsewhere classified, as per ACS 1916 Superficial injuries? A: ACS 1916 Superficial injuries instructs that T79.3 Post traumatic wound infection, not elsewhere classified and a code for the associated infectious agent should be assigned as additional codes if a superficial injury is infected. The instruction in the specialty standard should be followed despite T79.3 being an NEC code. However it does not preclude the assignment of a more specific code for the infection, such as cellulitis in the scenario cited. For example: Patient admitted for cellulitis of an infected blister of the index finger. Documentation in the clinical record confirms an associated infection with Staphylococcus aureus. The following codes would be assigned (and sequenced following the principles in ACS 0001 Principal diagnosis):
accd_coding_rules_-_15_march_2015_nz_review_updated_dec_2015.docx