Wiki DVT vs History of DVT/Pulmonary Embolism

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I am a HCC coder and we are having a debate in my office about coding DVTs and pulmonary embolisms.

Most of the physician notes we review just say something like "DVT - on Coumadin"

I have been told not to code a DVT or Pulmonary Embolism unless the patient is presenting to the hospital or physician office with it on that date, so I have been coding them as "history of" if it's not presently happening.

However, the DVT or PE NOS codes in the index are the same as the acute codes, so in that regard, I feel we should code the "acute" code, since the provider isn't stating "history of".

I am sure these patients have chronic DVTs or PEs, but the provider rarely documents it that way, and I have no way to query the provider.

Should we be coding these as history ofs or the NOS code?

Please help!
 
In your case, I would code "history of...."

Based on what your docs are giving you, it just sounds like the Coumadin is being prescribed as a "lifetime measure" to prevent reoccurrence

Don't forget Z51.81 and Z79.01 if they apply for you
 
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