# status of chronic conditions



## jmcalister (Apr 25, 2013)

OKay can anyone give guidance on the status of chronic condition definition- in fact a definition maybe in black and white becasue I am sure that will be asked next. Is it enough to list in your HPI pt is here for follow up of DM, HTN, and HLP. That is 3 chronic conditions listed or does the "status" mean they need to go more into detail. I know the examples I have seen are HTN stable on atentol or DM stable on Metformin but is that a must to get credit for 3 chronic conditions. PLease any insight would be helpful and anything clear in writing on the definition would be even more helpful.


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## mhstrauss (Apr 25, 2013)

jmcalister said:


> OKay can anyone give guidance on the status of chronic condition definition- in fact a definition maybe in black and white becasue I am sure that will be asked next. Is it enough to list in your HPI pt is here for follow up of DM, HTN, and HLP. That is 3 chronic conditions listed or does the "status" mean they need to go more into detail. I know the examples I have seen are HTN stable on atentol or DM stable on Metformin but is that a must to get credit for 3 chronic conditions. PLease any insight would be helpful and anything clear in writing on the definition would be even more helpful.



Here is an older thread about this with some good info.

https://www.aapc.com/memberarea/forums/showthread.php?t=24371

Simply listing the conditions with nothing said about them is not enough; the provider must state what the status is.

Check with your MAC for further guidance; if it happens to be Novitas, here is what they have to say about it:

6.What is meant by "Status of chronic conditions"?

In 1997 the Evaluation and Management (E/M) Guidelines were enhanced under the History of Present Illness (HPI) section of the 1995 score sheet to include the patient's chronic conditions the practitioner is following or in which an exacerbation may have occurred resulting in the chief complaint and the reason for the patient encounter. The documentation in the patient's medical record must clearly state a status of the chronic condition in order to meet the requirement under the History: HPI Status of 1, 2, or 3 Chronic Conditions on the 1995 score sheet. An example could be: hypertension - stable on Atenolol.

Hope this helps!


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## jmcalister (Apr 25, 2013)

thank you megan appreciate it much


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## amberlarsen820 (May 1, 2013)

I would like to add/ask....

You cannot use the status of 3 chronic conditions with the 1995 guidelines, right? I have found conflicting information on this. Most of our patients are Medicare patients. I looked on the WPS Medicare website and it states you cannot mix the 2 guidelines when coding/auditing.


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## RebeccaWoodward* (May 1, 2013)

amberlarsen820 said:


> I would like to add/ask....
> 
> You cannot use the status of 3 chronic conditions with the 1995 guidelines, right? I have found conflicting information on this. Most of our patients are Medicare patients. I looked on the WPS Medicare website and it states you cannot mix the 2 guidelines when coding/auditing.



Per Palmetto, the status of 3 chronic conditions can only be applied to the 97 guidelines.


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