The use of MEAT

LuckyLily

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Local Chapter Officer
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What do you think about the following examples being supported by MEAT?

E11.9 (Diabetes w/o complications) currently on Metformin 500mg.--Does the statement of the medication they are taking good enough to support?

F33.1 (Major depressive disorder, recurrent, moderate) followed by Dr. XYZ.--If its mentioned a doctor is following the condition, is this enough support?

Thank you
 

Pathos

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Per a good AAPC article:

"One way to help ensure your documentation is up-to-par for HCC coding is to include MEAT (monitored, evaluated, assessed/addressed and treated) in the medical record for the patient encounter. To break it down, documentation must reflect:
  • 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"
Another article from AHIMA explains:

Details about the MEAT approach are provided in Appendix D. Others use “TAMPER™”:

  • Treatment
  • Assessment
  • Monitor/Medicare
  • Plan
  • Evaluate
  • Referral


To break each example down:

E11.9 (Diabetes w/o complications) currently on Metformin 500mg.
  • TTreating medications
F33.1 (Major depressive disorder, recurrent, moderate) followed by Dr. XYZ
  • Referral

While they both may be supported by MEAT and TAMPER, I would like to see a little more information. Perhaps an educational note to the provider to allow additional information (not much) could tip the scales towards better and improved documentation.

I once listened into a great webinar about Risk Adjustment, and the presenter explained about when it comes down to validating each HCC with either MEAT or TAMPER. How much Risk your organization is willing to take on each HCC?,- especially when documentation doesn't fit neatly into any published guidelines. Also, any guidelines not published by CMS or Coding Clinic (both official sources) should be taken with a grain of salt (even these posts on this forum). The best thing you can do is arm yourself with as much knowledge as you can from both CMS and AHA Coding Clinic.

Hope that helps!
 

michiboo

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Hi there!

Can I ask, if provider doesn't document DM but you see medication of Metformin being mentioned in the documentation, not sufficient to capture DM, correct? need to query provider
 

Pathos

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Hi there!

Can I ask, if provider doesn't document DM but you see medication of Metformin being mentioned in the documentation, not sufficient to capture DM, correct? need to query provider
No, if the condition is not supported by MEAT, and not even documented at all you shouldn't code the condition.

Additionally, because Metformin can treat other conditions (infertility being one), I would not pick up a condition based on the treatment if documentation does not state the actual condition. Reporting an undocumented and unsupported condition is a huge risk to take.

The provider should be queried for additional information or flat out not code the condition.
 

tmmoreland2017

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DM documented is enough to pass a RADV audit. Diabetes is one of the many chronic conditions recognized by CMS that can be captured without MEAT/TAMPER per
CMS Medical Record Reviewer Guidance [PDF, 438KB] p.53-54

I agree with the comment about dx f33.1.

There is no minimum number of criteria of either acronym required to code the dx.
 

NIKI01

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Hello,
I would love to have some info on how to code for chronic condition when MD is not documenting that he/she rewieved medication list and agree,for example:
27-year-old female with extensive past history: hypertension, ESRDdialysis, lupus, hx. of C. difficile colitis presenting today for black stool. ED Provided did not document any medication that this patient is on.
however, in the EMR nursing note stated that meds were reviewed by this nurse: Insuline, Propranolol.
thank you so much,
 

mcdream

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DM documented is enough to pass a RADV audit. Diabetes is one of the many chronic conditions recognized by CMS that can be captured without MEAT/TAMPER per
CMS Medical Record Reviewer Guidance [PDF, 438KB] p.53-54

I agree with the comment about dx f33.1.

There is no minimum number of criteria of either acronym required to code the dx.
Tmmoreland- do you have a link (unable to locate via ref provided) list of chronic conditions recognized by CMS that can be captured without MEAT/TAMPER? I appreciate your time!
 

rmwinder

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What do you think about the following examples being supported by MEAT?

E11.9 (Diabetes w/o complications) currently on Metformin 500mg.--Does the statement of the medication they are taking good enough to support?

F33.1 (Major depressive disorder, recurrent, moderate) followed by Dr. XYZ.--If its mentioned a doctor is following the condition, is this enough support?

Thank you
It is in my opinion. :) Where I work, it is.
 
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