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Clarification on counting problem points?

K

ktews

Contributor
Messages
14
Location
Commerce City, CO
We have been getting conflicting information on counting problem points in patients with Crohn's (in our GI practice). If anyone can clarify we would really appreciate it. IE: In a patient with Crohn's who has abdominal pain and diarrhea. Two scenarios - doctor notes it is a Crohn's exacerbation; doctor notes it is POSSIBLE Crohn's exacerbation and is working the problems up (i.e. stool testing for C. diff, abd xray to rule out SBO). In the past we would count three problems but a new coder within our consulting firm is now saying this would only count as 1-2 problems. Did something new happen within the coding world that we missed?
 
I would disagree with the consulting firm. Because your doctor specifically is working up other possibilities (even though those symptoms are symptoms of Crohn's) but because he wants to rule out those symptoms being caused by something else, I would say they would count as three problems. For another example, if a patient has chronic COPD and is presenting with SOB, and the provider thinks the SOB could be because of pneumonia, I would count the COPD and the new SOB as two problems.
 
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