Medical Billing Coding - Past Med. Hx Diagnoses, cpt, codes
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Thread Topic: Past Med. Hx Diagnoses
Topic Originator: coder D
Post Date January 28, 2009 @ 9:41 AM
Past Med. Hx Diagnoses

coder D
January 28, 2009 @ 9:41 AM Reply  |  Email Friend   |  |Print  |  Top

If the physician lists diagnoses such as low back pain, irritable bowel disease, eczema, hx of colonoscopy showing internal hemorrhoids, polyps, diveriticular disease in the past medical history, do you need to code all these even if the patient isn't currently on meds?  Our coding auditor makes us code everything and we're questioning that.

F Tessa Bartels
February 12, 2009 @ 11:33 AM Reply  |  Email Friend   |  |Print  |  Top

Code only the reason(s) for the current visit. Past medical history should not be coded as Dx for today's visit.
F Tessa Bartels, CPC, CEMC

February 18, 2009 @ 11:38 AM Reply  |  Email Friend   |  |Print  |  Top

You would only code for the Lbp, IBS, adn ezcema.

coder D
February 18, 2009 @ 2:54 PM Reply  |  Email Friend   |  |Print  |  Top

We were told by a physician that once you have diverticulosis, you always have diverticulosis, is that right?

F Tessa Barte;s
February 18, 2009 @ 3:22 PM Reply  |  Email Friend   |  |Print  |  Top

Code ONLY the Dx for TODAY's visit ... even if patient still has a condition if s/he is not here today for that problem it is not a dx that needs to be coded.

For example:  patient here for finger laceration, and patient happens to have diverticulosis. You code only the wound.

If the physician is treating the condition at TODAY's visit, then you code the dx. Otherwise do not code it.

F Tessa Bartels, CPC, CEMC

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