Secondary Diagnoses

I am currently a medical coding student and I am having a hard time figuring out when to report secondary diagnoses. I have read the ICD-9 guidelines concerning secondary diagnoses, but I am looking for some additional help.

In the case study I am working on a patient is admitted with SOB and is diagnosed with fluid overload due to missed dialysis. The patient has ESRD, diabetes, arthritis, chronic hepatitis C, dyslipidemia, hypertension, secondary hyperparathyroidism, tobacco use, Anemia do to ESRD, hx of osteoporosis, hx of myocardial infarction, and hx of cocaine and heroin use.

I have determined that most of these diagnoses are essential to code, but I am unsure of a few(secondary hyperparathyroidism, arthritis, dyslipidemia, and hx of osteoporosis) . All of these diagnoses were documented in the diagnosis discharge summary. According to the guidelines:

"If the provider has included a diagnosis in the final diagnostic statement, such as the discharge summary or the face sheet, it should ordinarily be coded. Some providers include in the diagnostic statement resolved conditions or diagnoses and status-post procedures from previous admission that have no bearing on the current stay."

I feel as though the physician, in this case, may have reported conditions that may have no bearing on the patient's current care. How would you determine if the physician included diagnoses that should not be coded? In this case, would it be necessary to query the provider?

Any help would be appreciated! Thanks:)

re: Secondary Diagnoses

Conditions that the physician must manage or that affect the management of the patient are to be coded.