Wiki Is Cancer considered High Risk?

[SUEV]

There's been some discussion in our office regarding cancer risk. Would it be appropriate to consider any type of current cancer as High Risk under Presenting Problem in the MDM table? When a patient is dx'd with DCIS, adenocarcinoma or other type of breast cancers, the general surgeon bills a level 5 for the first visit. There are multiple ways to get to a 5 but the debate is whether cancer would be considered Moderate or High RISK to most coders.
Thanks for your opinions,
Sue​

 

[thomas7331]

I think it would be overly broad to say that a cancer diagnosis always equates to a certain level of risk - it depends more on the provider's documentation of their assessment of what level of risk that diagnosis presents to the patient. Certainly not all forms of cancer pose a high risk to patients' life or limb (e.g. some forms of skin cancer can even be low risk).

 

[SUEV]

I agree Thomas. I'm thinking High risk might be appropriate for cancers that involve treatment options that include chemotherapy and/or surgery but would appreciate other opinions also.
Thanks,
Sue​

 

[Tantoncic]

Chemo would fall at a "high" on the table of risk...."Drug therapy requiring intensive monitoring for toxicity"

 

[FTessaBartels]

Chemo would fall at a "high" on the table of risk...."Drug therapy requiring intensive monitoring for toxicity"

Yes, but a GENERAL SURGEON would not be managing the chemotherapy ....

F Tessa Bartels, CPC, CEMC