• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below.
  • We're introducing new features and a new look to make the forums easier to use and more valuable to you. See what's new and let us know what you think!

Question Acute Vs Chronic Vs Unspecified

ljones88

Networker
Messages
84
Location
Stuart, Florida
Best answers
0
Hi all,
I have scoured the ICD10-CM guidelines and I swore there was an actual "time" definition for acute vs chronic diagnosis codes but I can't find it and I need clarification.

I specifically remember attending coding-related training events where speakers (more then 1 and from various entities) advising that "4 weeks or less" is considered "acute" whereas "over 4 weeks" is considered "chronic".

FOR EXAMPLE: If the physician did not explicitly state in the MR the patient had "acute" otitis media BUT documented that the symptoms started "3 days ago" we could safely code to the "Acute otitis media" vs the "unspecified otitis media" because the doctor is documenting symptoms that occurred less then 4 weeks ago........now I'm questioning this rationale as being false cause I can't find anything to support it in 2019.
 

Chelle-Lynn

True Blue
Messages
645
Location
Modesto, CA
Best answers
0
We go by the rule of thumb that if the provider does not specify acute or chronic we use:

  • Acute: sudden onset and/or has limited duration
  • Chronic: on-going, usually lasting 6 months or longer. In addition a newly diagnosised illness can be considered chronic prior to the 6 months if there is no expectation of improvement or cure.

If the patient has multiple reoccurring ear infections it may be opportunity to query the provider on if the situation is becoming a chronic condition.
 

mitchellde

True Blue
Messages
13,308
Location
Columbia, MO
Best answers
0
It has always been my understanding that the provider must be the one to document whether a condition is acute or chronic and there is no rule of thumb for this. even though a condition may be a long term issue it may not be chronic by the providers medical opinion there is so much we just don't know and are not privy to as coders. There are instances when the guidelines tell us what to code for instance pain, they tell us if it is documented as postoperative pain then we default to acute even though the operative procedure could have been moths ago. so unless documented it is unspecified in my opinion.
 

kdlberg

Networker
Messages
38
Location
Orlando
Best answers
0
It has always been my understanding that the provider must be the one to document whether a condition is acute or chronic and there is no rule of thumb for this.
It is chronic if the provider says it is. If it isn't documented, you can't code for it. Now, if I saw several indicators this might be a chronic condition, I would query the provider (who could do an amendment.)
 
Top