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Orthopedic Coding Alert

Learn Why Acute Versus Chronic Matters

Published on Sat Sep 05, 2009

The acute versus chronic decision is important for many reasons. For instance, some state health information regulations require an E code as the secondary diagnosis when acute injuries are reported, and certain drugs are approved only for acute or chronic conditions. In addition, a patient encounter may qualify for a higher-level E/M code when the orthopedist treats several chronic conditions during the same visit. For instance, a low level of risk (often reported with levelthree codes, 99203 or 99213) in the E/M medical decision making (MDM) guidelines includes exams during which the orthopedist treats one stable chronic illness. A moderate level of MDM (relating to level-four codes, 99204 and 99214), however, involves treating two or more stable chronic illnesses. Problem: This can put intense pressure on orthopedic practices that can't always categorize patients' injuries and conditions.
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