Wiki Psoriasis and Arthritis

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Jchrist3614

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Hi everyone!

I am reviewing a medical record for risk adjustment purposes. The past medical history shows both Arthritis and Psoriasis but the assessment and plan states psoriatic arthritis. Psoriatic Arthritis maps to an HCC, but I'm wondering If I would also capture these DX separately as well or only if the relationship between the two wasn't listed? Member is on medication for Psoriasis.

Thanks!
 
Have you ever heard of or used the acronyms "MEAT" or "TAMPER" when coding risk adjustment? I've included a couple links that might help you determine whether you should capture the other two diagnoses from the past medical history. Also check with your department policy as every facility department is different on what is captured and what isn't. I wonder since the patient is being treated for the psoriasis you would capture this diagnosis. I think the arthritis may also be captured since it is related to the condition, "psoriatic arthritis."

 
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That makes sense. The assessment and plan states "Arthritis" and then says "impression: psoriatic". To me, you would then code L40.50, not both conditions separately like the practice originally did. I was second guessing myself because the past medical history lists both conditions separately as arthritis and psoriasis and does not link them together. I didn't realize when posting my question that unspecified arthritis alone doesn't map to an HCC anyway, I just didn't want to miss out on capturing everything in the documentation that was able to be captured. Thanks for your help!
 
I would always use the doctors assessment for the encounter over any past medical history that made be canned or aggregate. You are capturing the diagnosis for today’s encounter by this physician. If the provider linked them- I would certainly use that. Medications are not appropriate to code from either - they can give you hints, but since we aren’t the doctors we can’t interpret their use. I hope that helps.
 
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