Priority Order vs. Decision Rules

You know the drill.  You are coding a family using the DPICS and stumble upon a coding conundrum.

Should you use the priority order? What the heck is the priority order?  

Not sure??  Read on for this enlightening post by Dr. Rhea Chase…

One of the basic coding rules is that we can only code a verbalization as one DPICS category. This is tricky because there are many things parents say that represent two categories. So, for example, if a parent says, “You’re building a great tower!” that is both a BD and a LP. But we can’t code it in two categories, which is why we have the priority order. We use it when we know the statement is two categories, there is no question that it could technically be coded as two things, but we have to choose one. So it’s like we have to figure out which one “takes priority” over the other. In the priority order, LP trumps BD so in my above example, the statement is coded LP. One of the most frequent times that you’ll use the priority order is when the child describes their own behavior and the parent repeats them. So, a child may say, “I’m flying my plane in the air!” and the parent says, “You ARE flying your plane in the air!” The statement is both a BD and a RF so I use the priority order which says: RF!

Decision rules are used when you really don’t know what the heck a code is and you can’t decide between two categories. You’ve looked in the manual and you can’t figure it out, so you have to “make a decision.” If, for example, a parent said, “You’re drawing a gurty picture” and you weren’t sure if “gurty” was positive or not, and you were debating between a LP and a TA, then you would use the decision rule order. The decision rules are in opposite order of the priority order, so in this situation, you would code TA.

Chair, PCIT Communications

Posted in Clinician's Corner.

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