I am fairly new to the GI world but know that the crohn's and colitis codes blew up in specificity in 2015. I am struggling to understand when it is appropriate to diagnosis a complication of Crohn's or Colitis and any help is appreciated.
It is my understanding that when selecting the crohn's or colitis with complication codes, the complication must be documented as being current/active.
For example, patient has a diagnosis of large and small bowel crohn's. Several years back patient had a fistula that complicated his crohn's disease; however, the fistula since been resected and the patient has been treated now for a couple of years with Remicade with no current/active complications of his crohn's disease. Patient has had several follow up visits with no GI complaints and is doing well on treatment.
Question is, would the patient's diagnosis for all current visits that are documented with no GI complaints and doing well on treatment still be considered crohn's disease with complication?
If anyone can point me to any supporting documentation, that would also be very helpful.
It is my understanding that when selecting the crohn's or colitis with complication codes, the complication must be documented as being current/active.
For example, patient has a diagnosis of large and small bowel crohn's. Several years back patient had a fistula that complicated his crohn's disease; however, the fistula since been resected and the patient has been treated now for a couple of years with Remicade with no current/active complications of his crohn's disease. Patient has had several follow up visits with no GI complaints and is doing well on treatment.
Question is, would the patient's diagnosis for all current visits that are documented with no GI complaints and doing well on treatment still be considered crohn's disease with complication?
If anyone can point me to any supporting documentation, that would also be very helpful.