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Wiki Counting Diagnoses Question

O

Ortho Coder

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I have a general question. Say you have an established patient that has a stable meniscus tear, stable chondromalcia of the knee, and stable osteoarthritis all of the same knee. The provider treats all three diagnoses with the same treatment. Do you count 3 points (one for each diagnoses) or do you count only one point since all three were treated with the same treatment?
Thanks for any feedback!
 
Personally I would count them as three individual conditions, they may have been treated with the same procedure, but they are three different conditions that he is treating/assessing.
 
Unless they are symptoms of a condition which has been identified (for example - cough -> COPD; itching -> psoriasis), it has been my experience that you can count them towards the Risk table or Dx/Mx Options. If there is some overlap on conditions, then documentation should support medical necessity in order to bill for each condition.

In your example I would consider Osteoarthritis as one, and depending on documentation and treatment either do one of the knee conditions or both.
 
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