chandler80
Guest
- Messages
- 17
- Best answers
- 0
Is there a list of chronic conditions that is acceptable to code when listed in PFSH/PMH (and often times not mentioned any further in the office note)
Thank you
Thank you
Last edited:
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Past Medical History
- Thread starter chandler80
- Start date
FTessaBartels
Guest
Not treated = Not coded
If the chronic condition is mentioned ONLY in the history and is not being evaluated or treated, then I wouldn't code it.
But perhaps I'm not understanding your question ...
F Tessa Bartels, CPC, CPC-E/M
If the chronic condition is mentioned ONLY in the history and is not being evaluated or treated, then I wouldn't code it.
But perhaps I'm not understanding your question ...
F Tessa Bartels, CPC, CPC-E/M
okiesawyers
Expert
I agree with Tessa. A chronic condition or any condition for that matter should only be coded if it is addressed and treated in the A/P. Perhaps I am not understanding your question either. Let us know if we can help further!
katrinabgood
Networker
I was taught to code chronic conditions such as DM, HTN, and any that might have bearing on what pt is being treated for, such as GERD, COPD, CAD, etc... I have also been told to code all chronic conditions, as it gives "the BIG picture." Is this wrong? (I do ER coding in a hospital.)
sthibo
Guest
Guidelines
According to the ICD-9-CM Guidelines, Section IV-k, Code all documented conditions that coexist at the time of the encounter/visit, and require or affect patient care treatment or management. Do not code conditions that were previously treated and no longer exist. I hope this helps. You can find a lot of answers to questions in the Guidelines!
According to the ICD-9-CM Guidelines, Section IV-k, Code all documented conditions that coexist at the time of the encounter/visit, and require or affect patient care treatment or management. Do not code conditions that were previously treated and no longer exist. I hope this helps. You can find a lot of answers to questions in the Guidelines!
FTessaBartels
Guest
Whose the doctor?
I did not examine the patient. I did not take the history. I'm not a doctor (or any other healthcare provider). I don't know if the DM mentioned in the history has any impact on the broken ankle unless the doctor states so in the documentation.
If it's just in the history section with no further mention, I don't assign a Dx code.
The provider should document what was done. The coder should code what was documented.
F Tessa Bartels, CPC, CEMC
I did not examine the patient. I did not take the history. I'm not a doctor (or any other healthcare provider). I don't know if the DM mentioned in the history has any impact on the broken ankle unless the doctor states so in the documentation.
If it's just in the history section with no further mention, I don't assign a Dx code.
The provider should document what was done. The coder should code what was documented.
F Tessa Bartels, CPC, CEMC
katrinabgood
Networker
Thanks, sthibo! That's what I thought, but it certainly wouldn't hurt me to review the guidelines periodically!