Wiki Complexity of problem for a stable cancer patient

[sachenbach]

A hem/onc provider always documents that his patients, with an active cancer diagnosis, are considered to have a chronic illness that poses a threat to life or bodily function although he clearly states that the patient is doing well and stable on the current regimen.
I am just wondering if there are experienced hem/onc coders who are seeing this or what their thoughts are. I am not able to find any reference on this and would appreciate it if someone else has something.
Thanks so much.

 

[csperoni]

I do not consider every active cancer patient to be high level for problems. From the AMA 2021 outpatient guidelines:
Acute or chronic illness or injury that poses a threat to life or bodily function: An acute illness with systemic symptoms, an acute complicated injury, or a chronic illness or injury with exacerbation and/or progression or side effects of treatment, that poses a threat to life or bodily function in the near term without treatment. Examples may include acute myocardial infarction, pulmonary embolus, severe respiratory distress, progressive severe rheumatoid arthritis, psychiatric illness with potential threat to self or others, peritonitis, acute renal failure, or an abrupt change in neurologic status.
That "in the near term" phrase is key here. So a patient with a stage 4 aggressive cancer not responding to treatment might meet that description, but a patient with a stage 1 slow growing cancer would not.

 

[sachenbach]

I do not consider every active cancer patient to be high level for problems. From the AMA 2021 outpatient guidelines:
Acute or chronic illness or injury that poses a threat to life or bodily function: An acute illness with systemic symptoms, an acute complicated injury, or a chronic illness or injury with exacerbation and/or progression or side effects of treatment, that poses a threat to life or bodily function in the near term without treatment. Examples may include acute myocardial infarction, pulmonary embolus, severe respiratory distress, progressive severe rheumatoid arthritis, psychiatric illness with potential threat to self or others, peritonitis, acute renal failure, or an abrupt change in neurologic status.
That "in the near term" phrase is key here. So a patient with a stage 4 aggressive cancer not responding to treatment might meet that description, but a patient with a stage 1 slow growing cancer would not.

Thank you .........I did read this in the AMA E/M Office Visit Compendium 2021. I appreciate your response.