Don’t forget the buddies!

The coding world got upset during the Open Door Forum not too long ago. The CMS spokesperson was talking about the removal of data validity flags on etiology/manifestation pairs and said the grouper would capture the points if the manifestation was coded anywhere under the etiology.

Someone then asked for clarification and again he said that the manifestation did not have to be coded directly after the etiology (not an exact quote). The spokesperson was not speaking of the coding guidelines, but of the grouper and data validity flags. CMS is not overriding the coding guidelines and making a new rule just for us!

Coding guidelines are clear, and here’s a quote from Appendix D section 6 (December 2011) of the OASIS-C Guidance Manual from CMS:
“Criteria associated with etiology/manifestation pairs coding are listed below:

The etiology code is the underlying disease and must be sequenced first, before the code for a related manifestation. When a diagnosis is under consideration as an etiology diagnosis, the HHA is expected to ensure that a valid manifestation code is sequenced immediately following the assignment of the etiology code.”

So, don’t go breaking up your buddy codes!!

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