MDS Alert
Aim for Specificity to Code Idiopathic Gout
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Question: One of the residents on my wing is here for complications from gout, but the ICD-10 diagnosis code I’ve been using, M10.0, keeps coming up as “Return to Provider” in the ICD-10 mapping. Am I doing something wrong? Colorado Subscriber Answer: The code you were using isn’t specific enough; you need to include more information. For example, if the resident has issues from idiopathic gout that is affecting their shoulder, you should incorporate that information into your code choice. However, just including the site of the gout effect isn’t enough; M10.019 (Idiopathic gout, unspecified shoulder) also maps to the “Return to Provider” clinical category. In this scenario, knowing and documenting which shoulder is affected is crucial to choosing the diagnosis code that will map into a clinical category that pays. M10.011 (Idiopathic gout, right shoulder) and M10.012 (Idiopathic gout, left shoulder) both map to the “Non-Surgical Orthopedic/ Musculoskeletal” category for Patient-Driven Payment System (PDPM).
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Aim for Specificity to Code Idiopathic Gout
Question: One of the residents on my wing is here for complications from gout, but [...]