Wiki Medications

[Jchrist3614]

I am reviewing a chart and in the past medical history depression is listed. The member is actively taking Duloxetine which is used to treat multiple conditions, one being depression. This patient has more than one condition that this medication is used for and the chart does not specify which condition this medication is treating. Can I capture F32.9 based on depression being listed in the past medical history and the member currently taking Duloxetine? This would map to an RxHCC.

Thanks!

 

[SharonCollachi]

"Depression" doesn't necessarily mean "Major Depressive Disorder, Single Episode, Unspecified."

The ICD-9 code for Depression NOS was 311. Most mapping programs will put it as mapped to F32.9, as you stated above. However, when we were going thru conversion from ICD9 to ICD10, I asked all the mental health providers I was either working for or consulting for, and without fail, every single one of them said it was NOT Major Depression, Single, Unspecified.

 

[Jchrist3614]

"Depression" doesn't necessarily mean "Major Depressive Disorder, Single Episode, Unspecified."

The ICD-9 code for Depression NOS was 311. Most mapping programs will put it as mapped to F32.9, as you stated above. However, when we were going thru conversion from ICD9 to ICD10, I asked all the mental health providers I was either working for or consulting for, and without fail, every single one of them said it was NOT Major Depression, Single, Unspecified.

But when coding Depression if the type of depression is not specified in the medical record, F32.9 is the only code you can select if you cannot query the provider to be more specific.

 

[thomas7331]

I agree, F32.9 includes 'Depression NOS' - it does not have to be documented as a major depressive disorder to assign this code. That would be the correct code if it is not further specified. 'Major Depression, Single, Unspecified' is the code descriptor, not the diagnosis that the patient is required to have in order to use the code.

The organization I work for does allow (and in some cases actually requires) us to assign codes for conditions listed in history that are currently under treatment. However, given that the patient has multiple conditions for which this drug could be used, if the record is not clear as to which one the patient is taking this medication for, we would be expected to query the physician for clarification. If you are not able to query the physician, I think you'll need to reach out for guidance from you organization's internal auditors or quality team to find out what their expectations are for this.

 

[Jchrist3614]

I agree, F32.9 includes 'Depression NOS' - it does not have to be documented as a major depressive disorder to assign this code. That would be the correct code if it is not further specified. 'Major Depression, Single, Unspecified' is the code descriptor, not the diagnosis that the patient is required to have in order to use the code.

The organization I work for does allow (and in some cases actually requires) us to assign codes for conditions listed in history that are currently under treatment. However, given that the patient has multiple conditions for which this drug could be used, if the record is not clear as to which one the patient is taking this medication for, we would be expected to query the physician for clarification. If you are not able to query the physician, I think you'll need to reach out for guidance from you organization's internal auditors or quality team to find out what their expectations are for this.

Thank you so much for your help!!