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Re: [CCO-L] Diabetes coding / HCC coding

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  • Neil Tan
    from my experience, we can t pull it out from the HPI. The provider has to bring it down to assesment  ( say DM- good control or anything that he describe the
    Message 1 of 2 , Oct 1, 2012
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      from my experience, we can't pull it out from the HPI. The provider has to bring it down to assesment  ( say DM- good control or anything that he describe the diabetes condition, increase, decrease med)
       


      ________________________________
      From: Ericadschwalm <EricaDSchwalm@...>
      To: partb-l@...; coding@...; cco-l@yahoogroups.com; ericacodes@yahoogroups.com
      Sent: Friday, September 14, 2012 8:43 AM
      Subject: [CCO-L] Diabetes coding / HCC coding


       

      Per Coding Clinic 1992 Second Quarter pp. 16-17, diabetes mellitus listed in the "history" section of the medical record can be coded without further physician documentation other than the final face sheet. This is one of four diagnoses that CC addresses in this manner. The others are COPD, hypertension and Parkinson's disease. CC feels that these are chronic conditions that affect the patient for the rest of his/her life.

      So, for physician coding if DM listed in past history and then in the assessment as well, wouldn't you say that is good enough?

      I've got the nurse auditors stating that in the HPI, "sugars have been better" is insufficient documentation because "diabetes" is not specified ... but it is clearly there in the PMH and Assessment. They are stating there is no evealuative statement. I disagree.

      This is for HCC coding.

      Please let me know if I'm way off and if you have any docuemntation proving or disproving my opinion then please share.

      Thanks!

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