Wiki Angina - office

[KoBee]

there has been conversation if Angina should be captured in an office setting, some say yes and some say no as it considered an acute condition, anyone have any feedback how they capture it in their office or any recommendations.

 

[thomas7331]

It's captured if it's documented by the provider as being a current condition at the time of the encounter. Code assignment isn't treated differently for certain conditions and not others because of an office setting, at least that I've ever heard of.

I'm not sure I understand what you're being told about it being 'considered an acute condition' - what do they mean? That it only happens in the hospital or is only treated in the hospital? That doesn't make any sense. Many acute conditions are treated in the office, and angina certainly doesn't only occur or only get treatment in a facility. Angina can be an ongoing problem with some patients, and they aren't always hospitalized for it. So I don't know why you wouldn't capture it if that's the case.

 

[KoBee]

Angina pectoris can be captured in the outpatient setting (office) as long as the provider documents the condition as active/MEAT. However, unstable angina is not typically coded in outpatient setting unless patient sent emergently to ER.

https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain/unstable-angina

Hope this helps.

We have many providers who capture HCC " unstable angina " in outpatient office setting when there is no chest pain occurring or anything, just states below. Which if they capture it then it is saying patient is having onset chest pain right there and then and emergency treatment is needed, right!? So, what is provider to capture in this case or should it not be captured at all? Majority of the time patient is not coming to follow up on anything related to cardio conditions. It's just an HCC the provider picks up from a problem list to their chart note.

Any suggestions how to explain this to a provider? help :/

Unstable angina (HCC)
Stable. Follow up with Cardiologist

 

[amroach68]

It could be that you need to update your Problem List / Ongoing Problems section in the EHR. Some systems like Cerner allow for editing those from a diagnosis section of the program. If it's a constant problem coming up for many providers, you might want to look into that as a potential source of the problem.
If the documentation describes the condition as "stable," the implication is that they are not suffering from unstable angina. Any time there is conflicting information in the documentation, query the provider for clarification.