tci ED Coding & Reimbursement Alert - 2022 Issue Q1

Reader Questions: Find out When to Code Chronic Conditions

Question: One of our providers is saying that we should always code chronic conditions as chronic conditions with exacerbation because chronic conditions always have the capability of exacerbating at any time. However, I believe you can only code a chronic condition as chronic with exacerbation at the time of a visit when the patient is presenting with that exacerbation. Which of us is correct? Nebraska Subscriber Answer: Both ICD-10 and the AMA in the CPT® guidelines for the office/outpatient evaluation and management (E/M) codes view chronic illnesses with exacerbations in the same way: “An acute exacerbation is a...

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