# ACUTE and CHRONIC....HELP!!!!!!!



## Ladamato13 (Feb 25, 2014)

Hello! I am a fairly new coder and I am working for a company where I do mostly Radiology coding. My co-workers and I are recieveing some conflicting information about coding a condition that is unspecified as acute or chronic. I was taught in school and most of my co-workers were under the impression that if a condition is unspecified, we automatically code it as acute over chronic (when there is no unspecified code). I was just putting this out there to all of you to see what you were taught and you have been doing. If anyone has a link to a official guideline on this topic I would really appreciate if you could post it because I can't find an ICD-9 guideline or any "official" information on this. Thank you very much in advance!


----------



## melissa vasquez (Feb 26, 2014)

*acute/chronic*

It really depends on the code. Is there a specific code you question?


----------



## tharal (Feb 27, 2014)

Hi,

Acute and Chronic Conditions 
If the same condition is described as both acute (subacute) and chronic, and separate subentries exist in the Alphabetic Index at the same indentation level, code both and sequence the acute (subacute) code first. 


This is what we can found in ICD guideline. 

Your question is if a condition is not documented as acute or chronic, how it will be coded...?

see two examples here

1. Sinusitis not specified as acute or chronic

When we check the alphabetic index we can found that the default code for sinusitis will directs to 473.9 (the same which we can use for chronic sinusitis)

2. Pnuemonia NOS

The maini term pneumonia will go to 486 as default code (see Pneumonia (acute) ), which means for acute pneumonia we will get the code as 486.


For some conditions the default code will be acute and for some other conditions it will be chronic, but we cannot assume and code a condition as acute when its not stated as acute or chronic, the default code will use for such situations.

Hope it helps!

Thara L CPC H


----------



## MarcusM (Mar 4, 2014)

Acute typically means of a short duration and will probably heal in a few days to a few weeks. In the pain medicine world, acute is typically less than three months, and anything longer than three months is considered chronic. But, a patient can have an acute flare up of chronic back pain...or other acute flareup of a chronic condition.  So in radiology, you could have chronic lumbar stenosis, facet hypertrophy with an acute low back pain due to lumbar strain, and have an MRI to check for disc herniation(s).  If the signal intensity is abnormal, then the condition is probably acute overlaying a chronic condition.


----------

