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old vs new meniscus tears

  1. #11
    Question
    Medical Coding Books
    I always thought that it was 3 months or more to consider it an old injury and anything more recent than that would be considered a current injury. Is this correct?

  2. #12
    Default old vs new
    I will have to check, but I think I read somewhere that if they have had ongoing treatment and it's not resolved, then it's still coded as current. Say a knee injury 6 months ago, but they were trying conservative treatment first. Physical therapy, injections and such. Then they went for surgery, I still code the current instead of the chronic as the treatment never stopped.
    Unfortunately, I believe this is one of those that will never be agreed upon. LOL. Will see if I can find where I read and add when I do.

  3. #13
    Location
    Greeley, Colorado
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    2,045
    Default
    Thanks Anna!
    Lisa Bledsoe, CPC, CPMA

  4. #14
    Default old vs new
    Well, I have looked through all my Ortho information and I cannot find anywhere that lists a time frame on old vs new. So, I started looking at articles and such. WOW!! Was I educated.
    And the answer is: It depends!! LOL. Some say 6 weeks from injury is considered chronic. Some say 3 months is considered Chronic. Other's say it depends on the persons age or whether it was a traumatic injury. There really doesn't seem to be an answer that everyone agrees on. There are some really interesting articles out there though.
    Sorry, I really thought I had the answer to this one. LOL, looks like... not so much.

  5. #15
    Cool RE: old vs new
    Glad to hear everyone wondering about this one! As a new coder, I was very frustated by this and asked again and again and no one could really say when it is considered old and when it is new. I code them now as old unless they happened very recently, say a week. If you are going to be "dinged" for it, as someone mentioned above, doesn't there need to be a reference to refer to that you are violating? A guideline?

  6. #16
    Location
    Long Island/New York
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    Thumbs up
    Quote Originally Posted by jamshidi View Post
    glad to hear everyone wondering about this one! As a new coder, i was very frustated by this and asked again and again and no one could really say when it is considered old and when it is new. I code them now as old unless they happened very recently, say a week. If you are going to be "dinged" for it, as someone mentioned above, doesn't there need to be a reference to refer to that you are violating? A guideline?
    excellent point...i'd be interested to hear that

  7. #17
    Location
    Columbia, MO
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    12,531
    Default
    Also remeber we can use late effect codes and sometimes this is preferable to the 717 codes for instance if the encounter is for treatment of pain from the injury 2 weeks ago I would got for the pain and then the late effect code I think it more acurately fits. As for surgery then what are they correcting, if the y tried conservative methods and failed and moved straight to surgey then I say the tear is still current, if on the other hand the patient drug their fet for a long period of time and was not consistent witht the treatment and then the physician decided that the only cure was surgical I will lean towards the 717 codes, I think it is all very dependent on documentation and the old vs current is going to be left to the physician.

  8. Default
    #2 05-28-2009, 10:06 AM
    mbort
    True Blue Join Date: Apr 2007
    Location: ENGLEWOOD/DENVER
    Posts: 1,997




    --------------------------------------------------------------------------------

    I was always taught that you always code current tear (836.0/836.1) unless the surgeon specifically states that it is a degenerative tear(717.X series).

    I had a real hard time doing this for many years and argued and argued, and was noncompliant with what I had learned because I didnt want to give the patient an "injury" diagnosis...then one day....I was DINGED in an audit!!

    The example given was basically stating that if you always code degenerative, you are giving the patient a dx/disease they may or may not have.


    Hope this helps,
    Mary, CPC, COSC
    So Mary, if a Dr. states "medial and lateral meniscal tears, severe medial compartment osteoarthritis, synovitis, and a partial ACL tear" would you code 717.xx? Just want to clarify what you are saying.
    Last edited by vickimcneill; 07-24-2009 at 11:43 AM.

  9. #19
    Default
    I was told if they have a date or can recall an injury, it is acute. If it just happened over time, its chronic/old. My doctors almost never say anything about that in the Op report, so I go back in their office notes to see what happened. Is that wrong to do that?

  10. #20
    Location
    NEW ORLEANS
    Posts
    954
    Default
    This thread is very interesting. Some SAY 717.? Others say 836.0 , , I know SOMETIMES WHEN i coded IT AS 836.0 OR 836. the insurance company wanted an accident report-at least that's what the billers said, I work at an asc and we don't get the accident report.
    Last edited by codedog; 07-25-2009 at 05:53 PM.

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