Wiki ASC coding

[kchoward]

I currently code for an ASC and after a recent audit have been advised to start coding all chronic conditions and status codes that are listed in the patients H&P per the ICD-10 guidelines section 2 chapter 4; however, it states "These coding guidelines for outpatient diagnoses have been approved for use by hospitals/providers in coding and reporting hospital-based outpatient services and provider-based office visits." It has always been to my understanding for ASC coding to adhere only to Chapter 2, section 4.N of the ICD-10 coding guidelines which state "For ambulatory surgery, code the diagnosis for which the surgery was performed." Does anyone have any further insight or rules regarding whether we should or should not add chronic conditions? Thank you

 

[thomas7331]

By my understanding and reading of the guidelines, this entire section applies to all outpatient services and does not exclude ASCs. In other words, I don't think that the guidance given in section 4 N that you've quoted here in any way implies that for an ASC you would be exempt from following the requirements within the rest of the outpatient coding guidelines, including those in sections G and I which address the reporting of additional codes and coding for chronic conditions.

But regardless of how you interpret the official guidelines though, many providers nowadays participate in risk sharing programs with payers and are required to report, when appropriately documented, their patients' chronic conditions that co-exist and potentially affect treatment at a given encounter in order to be accurately reimbursed. If your facility is instructing you to do this, it's appropriate for you follow their guidance.