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Anugu Srinivas
Medical Coder
Bachelor of pharmacy,CCS
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Other Auditiors opinions on HPI status of Chronic conditions
I was doing a nursing home audit for two providers and there was differences of opinion as to what qualifies as a status of the chronic conditions. There documentation in the HPI is the patient is being seen for their monthly visit. Chronic problems being followed are diabetes, HTN, Hyperlipidemia, dementia, and Parkinson’s disease. Nursing reports no new questions or concerns at this time. There have been no new interval complaints from last seen. They are saying when the document "no new interval complaints" that is the status of the patient’s chronic conditions. To me that does not seem like a status–it is they have not had any acute issues since last time. Maybe I am thinking wrong???:confused:
Any help would be appreciated!!
Cholelithiasis with chronic cholecystitis with obstruction vs no obstruction
All Chronic Conditions Master List
Can someone please share a master list of all existing chronic conditions ICD-10 codes in CSV or excel format, or share a source from where I can download this info. I greatly appropriate your all help and time.
Kind Regards,
Muhammad Imran
3 Chronic conditions and level of service
Thank you
Chronic Immunosuppression
Dysmotility and chronic gastritis
E.R. E/M HPI for Sickle Cell-Is Acute Exacerbation Considered ‘Chronic Condition’ ?
Somehow, it didn’t seem right to label an acute exacerbation of a chronic condition as just a chronic condition.
To me, somehow that is like labeling a hyperglycemic incident as a chronic condition of diabetes?
Any thoughts?
Documenting chronic health problems with a comprehensive Preventive medicine visit
I understand the difference between a Medicare AW exam and the age appropriate exam CPT codes 99381-99387 and 99391-99397
My query lies with the later the none Medicare exam
Components include appropriate history and exam with preventative counseling based on age as well as risk factor reduction,Immunizations and diagnostic’s
Where the water gets muddied for me is when the patient has long term chronic problems which are all brought into the encounter as well.
Is it necessary ? to discuss the pt’s COPD ,NIDDM , sarcoidosis etc during their preventative medicine visit ,assuming all conditions are stable at the time of the visit and if so to what extent
Understanding that if there is a significantly problem or abnormality found or discussed such as an exacerbation of the pt’s COPD that would be addressed with an E&M.
What I want to be sure of is it necessary to address all comorbidities during a preventative visit with a separate assessment and plan for each
Obviously the patients entire health picture is taken into consideration for counseling etc however the focus sometimes shifts from preventative a follow up visit on the chronic problems Not to mention the extra time spent addressing each co morbidity
If anyone can provide insight or recommend literature to research I would appreciate it
Is there a way to bill for extended Preventative visit when the provider addressed several stable chronic medical problems,as they can be quite lengthy
Thank you in advance Cheri
Stable Chronic illnesses for MDM
HTN, NIDDM, cataract, BPH. These are prefixed with "e.g." on all the audit tools which I take to mean these are simply examples. Does anyone have a reference for all/other conditions that can be counted? Can I used CKD, CHF, etc?
Thanks