Wiki Coding stable conditions

[JaneFrazier]

Quick questions. Do you code a stable condition if mentioned in the plan "hypertension: stable"? When that is the only information you are giving, no mention of being on meds or any contributing factors, can that code go out on the claim when nothing (in the note) has been done with it? I know you can use it in your MDM, but I was always taught that you can not code stable unless you are referring to labs, meds, or other tests?!?

Thank you in advance.

 

[mitchellde]

You code only complaints and symptoms or definitive DX for the encounter plus any chronic conditions that are managed controlled or treated or any mentions as complicating factors.