Allergy Coding Alert
Reader Question: Chronic Conditions
Question: Is it appropriate to report a chronic condition such as COPD if a patient presents for an acute condition?
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Missouri Subscriber
Answer: Yes, it is appropriate to report ongoing, pre-existing conditions such as COPD (496, Chronic airway obstruction, not elsewhere classified; chronic obstructive lung disease) or allergic rhinitis (477) if the patient presents for a separate, acute condition. This practice is recommended from a medical records and coding perspective, and it also improves the quality of care.
The primary reason for the visit should be listed on the claim first, with all medically significant diagnoses listed subsequently. These "extra" diagnoses may justify the need for additional clinical evaluation or diagnostic procedures, or they may affect the evaluation and treatment of the acute condition that caused the visit. In either case, the complicating or pre-existing condition may warrant a higher-level E/M service than would otherwise be necessary. The complexity and number of coexisting conditions dictate how detailed an examination is necessary, and recording the additional diagnoses will help support E/M coding.
- Published on 2002-03-01
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