Wiki Chronic Conditions listed in PMH-Risk Adjustment

Create Wiki
N

Nkeith

Contributor
Messages
14
Best answers
0
If in an EMR in the Past Medical History section has a section for Diagnosis - RHEUMATOID ARTHRITIS, Osteoarthritis, Benign Essential Hypertension , Essential Hypertension ( yes both are present). However, none appear to be addressed in Exam and patient is present for Knot on the foot. There is also a note for Family History of Hypertension. The History also states ?Compliant with Medications" but doesn?t state what Meds or what they are for. I do not think we can use the diagnosis for Rheumatoid Arthritis, Hypertension, or osteoarthritis since I cannot see where it was monitored, Assessed or addressed in Exam. It does generate an HCC of 56 and we do need I think Physician would have to state something like ?Rheumatoid Arthritis ? Stable? or ?continuing on XYZ meds" to justify coding them. Can I get input from anyone ? Is there any documentation supporting that the Chronic condition must be supported?
Thanks in Advance!
 
Yes, there needs to be something that makes those conditions current in order to code them as current. I would not suggest making them current without specific medications listed or them being addressed during that visit.
 
You must log in or register to reply here.
Top