Principal diagnosis

Patient comes to outpatient clinic for D&C for Metrorhagia. She becomes hyoptensive and procedure is potponed and she is transferred to the hospital observation area.
Second senario, same history but this time is admitted to the hospital.
What will be the principal in the first and second senarios.
I am thinking the first senario pricipal will be Metrorrhagia and secondary Dx. Hypotension and the second senario Hypotension will be the principal.
Am I right?

Principal Diagnosis

[Patient is seen in the outpatient of a hospital for D&C for Metrorhagia. She becomes hyoptensive and procedure is postponed and she is transferred to the hospital observation area.
Second senario, same history but this time she is admitted to the hospital.
What will be the principal in the first and second senarios.
I am thinking the first senario the principal Dx will be Metrorrhagia and secondary Dx. Hypotension and the second senario Hypotension will be the principal.
Am I right?
I would highly appreciate your kind response.
Thank you again

principal diagnosis

The circumstances of inpatient admission always govern the selection of principal diagnosis. The principal diagnosis is defined in the Uniform Hospital Discharge Data Set (UHDDS) as "that condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care".

Who is billing?

These questions are confusing when it is not clear if we are talking about how the hospital is going to select their principal diagnosis/DRG or how the physician is going to code their H&P/consult. Which are you asking about?

Principal Diagnosis

Sorry for that. I am asking about the hospital's inpatient (Principal/DRG) and outpatient billing services.

It's confusing to me and I made up this senarios after reading how to select first listed condition in cases when patient is transferred from hospital's outpatient surgery to observation area verses admitting the patient. (I understood its different in each case).

She came for procedure D and C for metrorrhagia to the hospital's outpatient surgery clinic and developed a complication "Hypotension" and she was admitted to hospital. I do understand that while coding for the hospital the principal Dx will be Hypotension.

2. And what if the same senario but this time patient was put in observation area. what will be the case? outpatient? then will the primary diagnosis be Metrorhagia?


Thank you so much for your response.