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Data Element Name:   Admitting/Patient's Reason For Visit Diagnosis Code
SPARCS Data Element Number:  56
Record Positions:  1670 - 1675 Format-Length:  A/N - 6
Effective Date:  1/1/2003 Revision Date:  January 2003

Definition:

The diagnosis provided by the physician at the time of admission, which describes the patient's condition upon admission to the hospital. Since the Admitting/Patient's Reason For Visit Diagnosis is formulated before all tests and examinations are complete, it may have been stated in the form of a problem or symptom and it may differ from any of the final diagnoses recorded in the medical record.

Codes and Values:
  1. Must have been a valid ICD-9-CM code excluding the decimal point. To be valid, ICD-9-CM codes must have been entered at the most specific level to which they are classified in the ICD-9-CM Tabular List. Three digit codes further divided at the four digit level must have been entered using all four digits. Four digit codes further sub classified at the five digit level must have been entered using all five digits. Failure to enter all required digits in the diagnosis codes would have caused the record to be rejected.

  2. Must have been left justified and entered exactly as shown in the ICD-9-CM coding reference, excluding the decimal point, and space filled.

  3. E codes were not valid as Admitting/Patient's Reason For Visit Diagnosis Codes.E-codes were reported in External Cause-of-Injury Code (Data Element 57) and Place-of-Injury Code (Data Element 59).
Edit Applications:
  1. Ambulatory Surgery Only:
    Edits pertaining to ICD-9-CM codes were validated on the basis of the Discharge Date (Data Element 6) and Expected Principal Reimbursement (Data Element 21) depending on conditions described in Appendix N, which included age-specific and sex-specific diagnosis code conditions.

  2. Emergency Department Only:
    Edits pertaining to ICD-9-CM codes were validated on the basis of the Discharge Date (Data Element 6) depending on conditions described in Appendix N, which included age-specific and sex-specific diagnosis code conditions.