Recent content by Pathos

  1. Pathos

    Wiki Risk Adjustment

    I agree with Pam on both conditions. For pure coding purposes, the hypertension is receiving treatment (the T in MEAT, which you will learn more about in Risk Adjustment) with medication. The melanoma appears to be excised and removed, thus no longer considered active or current, which would...
  2. Pathos

    Wiki Vent Dependence

    It might seem like a basic question, but when it comes to coding, the rub is always in the chart note. Our organization always looks at ventilator dependency as only applicable if the provider documents it such. The chart must state ventilator dependency in order to apply this code, and is...
  3. Pathos

    Wiki Category II Code Question

    For Risk Adjustment purposes, 3078F-3077F serves no purpose in code validation as they are not ICD-10 codes.
  4. Pathos

    Wiki MEAT requirements with new E&M changes

    Like SKWashington I would also like to see your physician's argument reference basis. However, MEAT and E&M guidelines are not the same. They may overlap a little or even look similar, but we as HCC coders do not pick up codes based on E&M rules and guidelines. Unless there is a Coding Clinic or...
  5. Pathos

    Wiki Risk Adjustment and Telehealth visits

    Thanks for you reply! Do you have good reference to share on this?
  6. Pathos

    Wiki Morbid obesity coding

    Yup you got it! This Coding Clinic echoes what you and Siddharthaqa said:
  7. Pathos

    Wiki HCC's Risk adjustment reviews

    I have worked from home since March 2020, when the COVID restrictions really hit. Feel free to ask me any specific questions (or private message me).
  8. Pathos

    Wiki Urothelial cancer

    Agreed, in order to help you out more we would need more information of the urothelial cancer, including metastatic status (spread or non-spread).
  9. Pathos

    Wiki DM with HTN

    At the end of the day, the decision to pick up/not to pick up an HCC lies within your organization. Yes, we should follow the guidelines set forth by the ICD-10 book, along with the Coding Clinics, however there are so many gray areas (some done on purpose). I would caution to lean too much into...
  10. Pathos

    Wiki DM with HTN

    UPDATED: I agree with @thomas7331 on this one, and To help explain the "with" and causal link I got this nifty reference to explain a little further: Since DM and HTN are not specifically called out in the Index of any ICD-10 book I have seen, I would recommend we exercise caution when trying...
  11. Pathos

    Wiki Chronic Condition Coding in the ED

    In order to pick up HCC conditions, we need documentation to validate any HCC codes as active conditions. While we have the mostly clear-cut guidelines on how to pick up certain conditions, we have plenty of areas where things get a little more problematic. As @TThivierge mentions, we have the 9...
  12. Pathos

    Wiki MEAT to support DM complications

    I listened to an AAPC Risk Adjustment webinar once, and one of the take-aways was "How high of a risk your organization is willing to take". Yes, we definitely need to follow the rules and guidelines, but when it comes to the more gray areas we are kinda left to our own devices and logic. From...
  13. Pathos

    Wiki MEAT to support DM complications

    Agreed, you can link the labs to both DM2 w/ CKD and neuropathy. The labs are the MEAT in this instance.
  14. Pathos

    Wiki Diabetes 1 and Diabetes 2

    I agree with Thomas on this one. The Excludes 1 notes prohibit us from coding both E10 and E11. However, I would personally go with the code that is best supported if both conditions have MEAT documented. Is this a combined DM1 and DM2 (LADA) or DM 1.5? If the latter, then documentation must be...
  15. Pathos

    Wiki Capturing codes from Physical Exam with no MEAT or support

    You can code from anywhere in the chart as long as there is MEAT to be found. I consistently find MEAT in the HPI, Exam and some cases even in the infamous Problem List and Past Medical History. However, you need to be careful with the last two. Depending on how the chart was documented can make...
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