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Anyone have a list of High Risk Drugs ??

  1. #1
    Salt Lake North
    Cool Anyone have a list of High Risk Drugs ??
    Medical Coding Books
    I know that some drugs that patients get put them into High MDM due to toxicity and other factors. Does anyone out there have a list of these that they are willing to share? Fairly new to Psych coding and wanting to get up to speed ASAP. Thanks!

  2. #2
    North Carolina
    Since you posted this in Behavioral, I've copied the list (NOT all inclusive) from Palmetto GBA.

    Psychiatric drugs

    Lithium, valproic acid, some antidepressants (imipramine, amitriptyline, nortriptyline, doxepin, desipramine)

    The link doesn't work so if you want the other high risk drugs (NOT all inclusive), let me know and I can fax it to you.

  3. #3
    Can you tell me where on Palmetto's website you found this? Thanks
    Mandy Flagg, CPC, CEMC
    Compliance Auditor

  4. #4
    North Carolina
    Default xicity.pdf/$FIle/Drug_Therapy_Requiring_Intensive_Monitoring_for_To xicity.pdf

    The link doesn't work...probably because it's a PDF (?). Maybe you can find the PDF in Palmetto's search engine. If not, I can fax you a copy.

  5. #5
    I will try and find it, and if I can't I will respond again.
    Thanks for the info!
    Mandy Flagg, CPC, CEMC
    Compliance Auditor

  6. #6
    North Carolina

  7. #7
    Thanks! Got it!
    Mandy Flagg, CPC, CEMC
    Compliance Auditor

  8. #8
    Durham, NC
    Default E/m mdm
    If my documentation says the encounter would be a Moderate MDM, but the patient is on a high risk drug, should its inclusion push into a high LOS?
    - Thank you.

  9. #9
    Dover Seacoast New Hampshire
    We actually do have a list of high risk medications that is published by our hosptial as part of the care planning and protocols that are in place as a written policy. Interestingly, drugs that you might not consider "high risk" are on here, including insulin and synthroid. However, there's more to determining the patient risk than noting the prescription of a high risk drug. You also must look at the route of delivery, whether or not the dosage is at a therapeutic level, how much ongoing monitoring is involved in getting (and keeping) it at therepeutic level, adverse effects, contraindications, and how long the patient has been on the drug...and so forth. Asking the providers to document all that information is my biggest challenge!

    If only it was straightforward.....

    One example I give my providers who want to get high MDM for a patient on Coumadin, is that they have to show me that they are doing 'intensive monitoring' of this drug. So if the patient has been successfully prescribed Coumadin (or Warfarin) for a year, and only goes for PT-INR every month or two, and remains on the same dose...well, that's not intensive monitoring, in my opinion. So I'd give only moderate risk here, and probably only low MDM, if there's only the stable condition as a single diagnosis.
    Pam Brooks, MHA, COC, PCS, CPC, AAPC Fellow
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

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