no admission diagnoses for hospital encounter

[petero]

I grabbed an old ER medical records packet I've had regarding a postictal trip to the ER a while ago.
Initially I was scouring it for information of an ictal period I had that ended up about 12 hours long, of which I have maybe 1 minute of overall recollection. Since then I have been trying to figure out what happened, and my mom (who was there) has been no help. She said I was just sleeping there, which makes no sense and has felt like a lie since she told me. My recollection of it is very traumatic, but nonsensical and almost non-existent, but still incredibly intense.

So I look over this packet again and at the top it says:
"No admission diagnoses for hospital encounter"

what does this statement mean to you?

 

[Fedup]

petero

From the 1 trip to the hospital (ok maybe more) I had it sounds like what I was told a long time ago and basically they ment, between them they were unsure to do anything or afraid and sent you home for an eye to be keep on you with the follow up tests, whatever they maybe. They might phrase things differently in America but its pretty much the same I think, I could be wrong.

 

[mamasita]

Admission diagnosis or admitting diagnosis

is usually a code (letter and number) that is given by the admitting doctor for why you are visiting the the lovely Hospital Inn, onder: for example: stroke (code bla,bla), cut toe (code bla bla). that way the correct tests can be ordered, the person can be sent to the correct floor, and the insurance companies or visitor can be billed properly.

Why yours said "no admission diagnosis" is a little odd..
could be elsewhere in the admission/discharge papers??
or they were idiots and not sure why you were there, but were keeping you for observation...or the billing clerk messed up. could be anything.
K

 

[kirsten]

I haven't heard of the phrase before but to me it sounds as though it means they did not make a diagnosis when you were admitted. Given that you were post-ictal, you probably didn't tell them that you had had a seizure or had epilepsy and perhaps your mother didn't tell them either. I have run into this issue before in relation to a doctor's consultation. He had to investigate before he could diagnose, so he submitted the medical aid claim without a diagnosis (and thus no ICD code.) The medical aid wouldn't pay because there was no diagnosis. I went back to the doc and asked him to resubmit with the diagnosis he'd arrived at later and the insurer then covered the consultation and tests,

In my country a lack of diagnosis on admission would be problematic for medical aid payment because the insurer pays only when there is a diagnosis attached. I have been in situations where doctors have put the wrong diagnosis onto the medical aid coverage form. I've often gone back to them and insisted they alter the diagnosis so that I can get coverage. I've never come across a doctor who was unwilling to do this, since their ethical obligation is with the patient, not the insurer. A lack of diagnosis during an admission or doctor's visit is sometimes a case of laziness on the medical staff's part. Then it's up to us to make sure we get the kind of care that is due to us.

 

[Chelsea]

Hmmmm, did they bill insurance? If they did, you can call the insurance company and find out the diagnoses and procedure codes! I've done this before and was astounded to find that it was written 000000 on the ER sheet, and when I called it was "generalized convulsive epilepsy-with mention of intractability" and "anoxic brain damage". No doctor ever mentioned the brain damage part! I once made an appointment at the Mayo Clinic in Jacksonville, FL, and they had on my information the ICD-9-CM code for a big toe infection. I politely reminded them that I was not going to the Mayo to have my toe amputated. Best wishes in finding out! CNN

 

[kirsten]

Chelsea, one of my doctors purposefully overstates the medical problem to my medical aid to improve my chances of getting coverage--so before you settle on brain damage, I would ask the doc whether that code was truthfully included or added to gain coverage.

 

[Chelsea]

I hadn't even thought of this! Here, though, Blue Cross and Blue Shield would've investigated the claim if it had been overstated. Pffff, insurance companies. Although it is 2:28 a.m. here, and I probably just am tired.

 

[kirsten]

The way I've seen doctors do it is to make the most of a suspicion they doubt is true, or they state a possibility that cannot be proven. In other words they'd be able to back their claim but it doesn't hold enough water to really investigate in terrible depth.