Wiki High risk?

[ktews]

Pt needs egd/colonoscopy. Chronic narcotic use so harder to sedate and procedure will be in hospital with propofol. Would I use v58.69 and would this constitute high risk (level 5 coding)?

 

[coachlang3]

High risk for what? the colon? Or the E/M code?

High risk for colon is only in cases of colon cancer screening.

need more info to give you correct answer.

 

[ktews]

sorry, E/M code is where I am confused. Wondering if level 4 or level 5 because pt at "high risk" for procedure due to chronic narcotic use and need for propofol sedation during procedure.

 

[coachlang3]

I'd have to say no.

Basically, high risk in MDM is for life threatening problems. Chronic or acute problems that can be considered life threatening and are worsening.

Chronic narcotic use is contributory to those problems but it wouldn't be a catalyst for high risk.

 

[ktews]

Ok, thank you. I was also told that in this case, the anesthesiologist is the one taking the risk, not the GI doc.