Wiki Chronic Condition Classification

[amieras]

Hello,

I was hoping to get an opinion on the Chronic Condition Table as defined by Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project.
https://hcup-us.ahrq.gov/toolssoftware/chronic_icd10/CCIR-User-Guide-v2023-1.pdf

My understanding is that the agency above puts ICD-10 into 3 categories: chronic, non-chronic, and no determination. Even if a condition is classified as non-chronic, it may become a chronic problem if the condition lasts 12 months or longer and meets one or both of the following criteria:
• The condition results in the need for ongoing intervention with medical products, treatment, services, and special equipment
• The condition places limitations on self-care, independent living, and social interactions.

We are a large podiatry group and I reviewed the list of our top 30 ICD-10s used by our practice and was surprised to see that so many of the conditions we typically treat for are listed in the non-chronic category. Would you agree or disagree with my determination that a non-chronic condition can be chronic if the criteria are met and documented within the medical record?

Thank you in advance for any advice!

 

[thomas7331]

Sure, what is non-chronic for one patient may be chronic for another in many cases. However, that doesn't seem to be the purpose of the classification tool that is described in the document that you linked here. In reading through it, it appears to me that the developers are creating a tool that allows a condition to be identified as chronic based solely on the information contained in the code descriptor itself and not on the content of individual medical records.

The section 'Identifying Diagnoses as Not Chronic Conditions' on page 13 provides additional information which describes the methodology:

Diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified (i.e., we do not know the condition has lasted 12 months or longer) in the code description are considered not chronic. For example, certain codes indicating visual loss (ICD-10-CM diagnosis codes in the range H53.121-H53.139) are considered not chronic as the code description does not indicate the duration of the loss of vision.

So they do acknowledge here that this condition could indeed be chronic, but that they are not classifying it as such because it cannot be so determined from the code description alone.