ICD Principal Diagnosis selection

If both Deep Vein Thrombosis and Pulmonary Embolism are present at admission, treated during admission and both seem to be equal in amount of resources expended toward them, does it matter which diagnosis goes first for principal diagnosis, when coding for an acute care inpatient hospital?

re: ICD Principal Diagnosis selection

I'll give the medical answer- the PE goes first. DVT can be treated as an outpatient, not PE so that is the main reason for admission.

re: ICD Principal Diagnosis selection

According to coding guidelines if both are present at admission both equally treated, then either can be principal. There is nothing in coding clinic that says the PE must be sequenced first. DVT as principal with PE listed secondary has a higher weighted DRG, in other words more reimbursement. However, you could query the doctor and ask him to choose. So it's not incorrect to list DVT first.

re: ICD Principal Diagnosis selection

Oh, then definitely go for DVT first! The DVT caused the PE so coding it first makes sense.