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    Risk Adjustment Chart Review

    Obviously the higher the patients risk score is the sicker they are. The insurance companies are then in turn putting out more money for these patients. If the chronic diagnoses are NOT being captured but the patient is still requiring these "higher needs" visits because they are indeed sicker...
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    99406 denial for medicare

    "These are time-based codes and time spent with the patient must be documented in the medical record. When documentation supports that a significant, separately identifiable problem-oriented evaluation and management (E/M) service is rendered, the appropriate code for the E/M service may be...
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    Hcc coding for pacemaker

    If there is a definitive code for a diagnosis you need to go for that code. Pacemaker has it's own code so you need to use the Z95.0
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    can you code Hepatits B as chronic from the PMH

    I am a risk adjustment coder and am presently auditing the chart reviews of one of our vendors. Hepatitis B is in the current diagnosis list and consistently being mentioned in the note so I have no problem with Hep B being coded as B19.10, they are stating that since Hepatitis B is also listed...
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    risk adjustment coding

    I am an HCC coder for a payer. A lot of the "chronic conditions" are on the HCC list, we tell our providers to DOCUMENT and code any chronic condition the member has. The rule is to "code all documented conditions that co-exist at the time of the encounter/visit and require or affect patient...
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    ICD 10 for indwelling Foley catheter

    Can someone please tell me the proper ICD 10 code to use for the presence of an Indwelling foley catheter? I can't seem to find anything appropriate. Thank you
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    How to code HASHD

    We have a doctor that continually documents HASHD (hypertensive arteriosclerotic heart disease). I can find hypertensive Heart disease and arteriosclerotic heart disease but nothing that would capture the whole diagnosis. Anyone have any ideas as to how to code this?
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    Can you list 12 diagnosis and only 1 CPT

    Thank you that is very helpful
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    Can you list 12 diagnosis and only 1 CPT

    I am wondering if you can put 12 diagnoses in line 21 when you are only using one CPT code pointing to four of these diagnoses. If a patient sees the provider and has acute and chronic diagnoses that need reporting, for risk adjustment purposes, but only one CPT is required for the visit, is...