Wiki Screening Dx

Messages
30
Best answers
0
Question when a provider is using a screening code such as screening for HIV, Screening for Hep C, and STD etc and placed an order. This would be counted as amount and complexity of data correct and not as undiagnosed new problem with uncertain prognosis? I don't believe this is an accurate dx to be considered a problem and used as such. Thoughts?
 
I am not an expert, here are my thoughts: 1. This would be counted as amount and complexity of data. 2. dx will be the reason for these tests like signs and symptoms Or (like in your case I believe) just Z code- screening for .... Z code to me would not represent dx to count for Problems.
 
I am not an expert, here are my thoughts: 1. This would be counted as amount and complexity of data. 2. dx will be the reason for these tests like signs and symptoms Or (like in your case I believe) just Z code- screening for .... Z code to me would not represent dx to count for Problems.
Thank you! That's how I feel. My provider seems to think otherwise as well as my billing manager.
 
AMA has recently clarified the definition: "A problem in the differential diagnosis that represents a condition likely to result in a high risk of morbidity without treatment." If the patient is completely asymptomatic, then you're at minimal risk because they don't have a presenting problem. If the test is being done because the patient has symptoms and thinks they've been exposed, you could call it an undiagnosed new problem--because maybe it's HIV, or maybe it's some other viral infection.

NAMAS also had a great example. Patient has a rash. We'd normally say that's acute uncomplicated. However, it's a circular rash, the patient recently came back from a camping trip, and while showering, they found a tick. Patient needs testing because they could have Lyme disease, ringworm, or dermatitis. It's the context that makes it more complex. So in your example, does the patient have other factors that make the provider suspect HIV or hepatitis?
 
AMA has recently clarified the definition: "A problem in the differential diagnosis that represents a condition likely to result in a high risk of morbidity without treatment." If the patient is completely asymptomatic, then you're at minimal risk because they don't have a presenting problem. If the test is being done because the patient has symptoms and thinks they've been exposed, you could call it an undiagnosed new problem--because maybe it's HIV, or maybe it's some other viral infection.

NAMAS also had a great example. Patient has a rash. We'd normally say that's acute uncomplicated. However, it's a circular rash, the patient recently came back from a camping trip, and while showering, they found a tick. Patient needs testing because they could have Lyme disease, ringworm, or dermatitis. It's the context that makes it more complex. So in your example, does the patient have other factors that make the provider suspect HIV or hepatitis?
Patient had no symptoms to justify it being a problem. Patient is Opioid Dependent so testing was to rule out dx due to patients history of drug abuse.
 
Then no, it is not considered a new problem with an uncertain prognosis. You were correct that the testing falls under "amount and complexity of data." I provided the definition and example so you can show the provider/billing manager if they want to push back on it.
 
Top