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Acute and Chronic conditions

  1. #1
    Default Acute and Chronic conditions
    Exam Training Packages
    Performing an Audit and see that provider diagnosed "recurrent sinusitis" and coder coded as "chronic sinusitis". It was my understanding that if the provider didn't state acute or chronic specifically that we as coders could not code it as such. Am I correct in my thinking? I can't find any supporting documentation to back it up. Can anyone help? Thanks, so much.

  2. #2
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    The definition of chronic is "persistent, continuing, or recurrent" according to the medical dictionary in Encoder Pro.

    Hope this helps!
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  3. #3
    Default Acute and Chronic conditions
    Agree with the definition, however a recurrent problem doesn't necessarily mean it is a chronic condition. How long do you have to have a recurrent problem for it to be considered chronic?

    Coders do not diagnose patients, physicians do. We can query physicians.

  4. Default
    Regardless, if it does not say ACUTE, it always codes to chronic sinusitis.

  5. Default
    There is no code for recurrent either.
    Basically , when a condition recurs again and again, it is off the hook of "acute". That means the sinus has the persistent focus of inflammation there -which merits for chronicity. Some times, when the chronic condition which is quiescent suddenly erupts and shows up with all its severity, then there is a term used called "acute exacerbation". For (eg) in chronic Asthma, we call acute exacerbation (status Asthmaticus).
    So, I agree with CMCGARY

  6. #6
    Default
    guru is correct if condition is not stated as acute you can only code it with the chronic code

  7. #7
    Default Oops - boy did I state that wrong - it was tonsillitis
    Oh my goodness! I'm sorry everyone - it was "recurrent tonsillitis'. I feel so silly now!

    Correct scenario - provider documents "recurrent tonsillitis", coder coded 474.00. I say it should be 463 because provider didn't state chronic.

    Thank you all so much for your earlier input. How about this one???

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