Wiki Personal history coding question

[JesseL]

I'm seeing a lot of conflicting information regarding this.

If a new patient is being seen and has "hypertension" noted on the history but not treated by the provider, do we code condition (I10) or the history code (Z86.79)?

I'm reading that if the condition is active then you should code the condition.

If it's not active then history should be coded.

But if you're not treating it then history should be coded.

Based on the above situation, I should code neither?

 

[amla12]

History of...can be confusing

A chronic condition that the patient still has, is active. One quick way to tell is to check if the patient is currently on some form of management for it - keeping in mind of course, that management does not always mean 'medication' but can also mean lifestyle changes.

 

[marnie2907]

I need some help specific with UHC Medicaid Florida
When we submitted a claim for well child care, is denial because EPSDT were not complete, everything looks good in the claim, modifier 25 is added, all the boxes for EPSDT are check,
There is someone with the same problem can give me any advise