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dballard2004

dballard2004

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This is a hypothetical question......let's say a patient comes into the clinic for follow-up of type II diabetes. The provider notes in the HPI that the patient has type II diabetes, is insulin dependent, and has been diabetic for 2 years.

Could you interpret the term "type II" as being severity? Would "insulin dependent" be considered as severity as well or could this be modifying factors?

Thanks.
 
Neither

I think with Type 2 Diabetes you have a chronic condition or a diagnosis. But neither severity nor modifying factor. I think severity or modifying factors would relate to symptoms that the patient might be experiencing. But there is no mention of that.
But I'm open to other interpertations.

Jim
 
Quality

I would consider "Type II" and "insulin dependent" as QUALITY.

If the physician had mentioned something along the lines of "the patient is having difficulty maintaining an acceptable range of BG levels, with occasional readings as high as 280" I would consider THAT as severity.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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