Coding Clinic Q1 is out! (Part 1)
The first-quarter Coding Clinic is available and offers several updates with meaningful implications for CDI and coding practice. After reviewing the guidance, a few key items stood out as especially important to highlight and share.
New Technology updates
Three new substance values were added to Table XW0 (Introduction of Anatomical Regions) under New Technology Group 11:
– Alpha‑1 Proteinase Inhibitor
– Anitocabtagene Autoleucel immunotherapy
– Somatic stem cells
Learn about these substances on pages 19 and 20.
Hypothyroidism and dementia
There is a presumed relationship; code them as related unless documentation clearly states otherwise or another guideline requires explicit linkage.
Important reminder: Coding Clinic guidance is scenario‑specific. The dementia/epilepsy guidance from Q2 2024 doesn’t automatically apply to other conditions.
GLP‑1 adverse effects (Ozempic and tirzepatide)
Adverse effects of GLP-1s are coded to T38.895A (other hormones and synthetic substitutes), not hypoglycemic agents. (Pages 24 and 25) Also confirmed: there is no specific code for long‑term GLP‑1 use.
Starvation ketoacidosis
For documentation of starvation ketoacidosis in a patient with an elevated anion gap metabolic acidosis with poor nutritional intake for over 2 weeks, assign: E87.29 – Other acidosis and T73.0XXA – Starvation, initial encounter.
OB coding pearls
For elective C‑sections without current complications, use O82 – Encounter for cesarean delivery without indication (pages 27–28).
Cirrhosis clarifications
Documentation of NASH cirrhosis: Assign codes K75.81, Nonalcoholic steatohepatitis (NASH), and K74.69, Other cirrhosis of the liver.
Documentation of Cirrhosis due to chronic Hep C is assigned K74.69, Other cirrhosis of liver, instead of K74.60, Unspecified cirrhosis of liver, from previous guidance provided in First Quarter 2018.
AKI guidance (pages 30–31)
For documentation of AKI secondary to rhabdomyolysis or hypotension, assign code N17.8 – Other acute kidney failure, with an additional code for the underlying cause.
Takeaway: A full review of Coding Clinic is essential to ensure you’re applying the most current guidance with the appropriate context. Precision, education, and teamwork matter, and this guidance reinforces the vital role coding and CDI professionals play in getting it right. So many great reminders, especially around assumed relationships, guideline specificity, and accurate code selection. Perfect content for CDI education and provider discussions.
