Question MEAT to support DM complications

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Portland, OR
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Hi, my question is about MEAT to support specifically diabetic complications. If I have a provider coding:


-Type 2 diabetes mellitus with stage 2 chronic kidney disease, without long-term current use of insulin (HCC)
CBC with Differential
Comprehensive Metabolic Panel
Hemoglobin A1C
-Type 2 diabetes mellitus with neuropathy (HCC)
CBC with Differential
Comprehensive Metabolic Panel
Hemoglobin A1C

There is no other documentation in the provider note about CKD or neuropathy. The provider did not drop a code for the CKD separately.

Do the lab orders count as enough 'MEAT' to code both the E11.22 & E11.40? Even though there is no documentation from the provider saying "neuropathy stable" or "CKD stable" for example?
 

Criket4

New
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Las Vegas, NV
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Hi, my question is about MEAT to support specifically diabetic complications. If I have a provider coding:


-Type 2 diabetes mellitus with stage 2 chronic kidney disease, without long-term current use of insulin (HCC)
CBC with Differential
Comprehensive Metabolic Panel
Hemoglobin A1C
-Type 2 diabetes mellitus with neuropathy (HCC)
CBC with Differential
Comprehensive Metabolic Panel
Hemoglobin A1C

There is no other documentation in the provider note about CKD or neuropathy. The provider did not drop a code for the CKD separately.

Do the lab orders count as enough 'MEAT' to code both the E11.22 & E11.40? Even though there is no documentation from the provider saying "neuropathy stable" or "CKD stable" for example?
Technically, there is no provider evaluation or plan for this scenario. It should be provided. My opinion. It's not a clear determination when it comes to review time. And it will!
 

Pathos

True Blue
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Beaverton OR
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I listened to an AAPC Risk Adjustment webinar once, and one of the take-aways was "How high of a risk your organization is willing to take". Yes, we definitely need to follow the rules and guidelines, but when it comes to the more gray areas we are kinda left to our own devices and logic.

From AAPC's own blogger:

  • MMonitoring signs, symptoms, disease progression, disease regression
  • E Evaluating test results, medication effectiveness, response to treatment
  • A Assessing/Addressing ordered tests, discussion, review records, counseling
  • TTreating medications, therapies, other modalities
The E in MEAT is Evaluation and describes test results, which is also the labs in the example given. It's not great, but we get to code the junk we are given. Would I liked more explanation and better documentation? Heck yeah! But I would still pick up E11.22 and E11.40 if I only had the above documentation as MEAT.
 
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