![]() ![]() Some of these underlying conditions include Parkinson's, Alzheimer's, multiple sclerosis, and traumatic brain injury. If coding dementia in other diseases classified elsewhere (F02.8X), always code the underlying physiological condition first, as F02.80 and F02.81 are manifestation codes and should not be used alone. They include unspecified dementia (F03.XX), vascular dementia (F01.XX), dementia in other diseases classified elsewhere (F02.8X), and Alzheimer's disease (G30.X), among others. Z94.9 is an unspecified transplant code and does not risk adjust.ĭementia with and without complications are two newer HCC categories. These codes also provide additional information regarding the organ that was transplanted to assist with after-care or monitor for complications. Some transplant status codes (e.g., Z94.X and Z94.XX) risk adjust and are used to indicate that a transplant has already occurred. Unspecified obesity (E66.9) is not a risk-adjusted diagnosis. Morbid obesity should also be coded with the appropriate ICD-10 code for the patient's BMI. Morbid obesity with alveolar hypoventilation (E66.2). Morbid obesity due to excess calories (E66.01), Morbid obesity is a risk-adjusted diagnosis, including: Unspecified CKD (N18.9) and unspecified kidney failure (N19) do not risk adjust, so specificity is important.ĭependence on renal dialysis (Z99.2) is a risk-adjusted condition.Ītherosclerosis (I70.XXX) and peripheral vascular diseases (I73.XX) are risk-adjusted diagnoses. ![]() Stage 1 and stage 2 CKD do not risk adjust only stages 3–5 of CKD (N18.3-N18.5) risk adjust.Įnd stage renal disease (N18.6) risk adjusts. Other specified cardiac arrhythmias (I49.8) and unspecified cardiac arrythmia (I49.9) are not risk-adjusted diagnoses.ĬKD and end-stage renal disease (HCC 136–138) Ventricular fibrillation and flutter (I49.0X). Tobacco use and nicotine dependence do not risk adjust.Ĭertain specified arrhythmia codes risk adjust, including: These codes apply to abuse of alcohol, opioids, cannabis, cocaine, sedatives, hypnotics, and other substances. Many substance abuse and dependence codes risk adjust but require specificity, including information about whether the patient is in remission or presenting with intoxication or withdrawal, or whether the condition is uncomplicated vs. Substance abuse and dependence disorders (HCC 54-56) But they're weighted differently, so be as specific as you can, using the appropriate I20.X diagnosis code.Ĭhronic lower respiratory diseases (HCC 111)Ĭhronic bronchitis (J41.X), emphysema (J43.X), and chronic obstructive pulmonary disease (J44.X) are all risk-adjusted diagnoses. Try to be as specific as possible - right, left, systolic, diastolic, acute, chronic, etc.Īll angina diagnoses risk adjust, even unspecified angina (I20.9). Unspecified viral hepatitis (B19.X) does not risk adjust.Īll heart failure diagnoses risk adjust use codes I50.XXX. But F32.9 (major depressive disorder, single episode, unspecified) does not.Ĭhronic viral hepatitis (B18.X) is a risk-adjusted diagnosis. Most major depressive disorder diagnoses, both single-episode (F32.X) and recurrent (F33.X), risk adjust. Typically, if the combination code is found in the EHR, then the EHR will add both diagnosis codes to the claim.ĭocumentation should match the codes being used. Current long-term use of insulin is risk adjusted use code Z79.4 Long-term insulin use should be coded separately if there is no combination code in the EHR (i.e., diabetes with long-term insulin use). ![]() If the patient also has chronic kidney disease (CKD), use the additional diagnosis code (N18.X) to identify the stage of CKD, as those codes also risk adjust. The codes include the complications (“with” or “without”), such as type 2 diabetes mellitus with diabetic nephropathy (E11.21). This is the most common mistake made when coding for cancers.Īll diabetes diagnosis codes risk adjust, but specificity and accuracy are important.ĭiabetes diagnosis codes are combination codes that indicate not only the type of diabetes but also the body system affected and the complications affecting those body systems. Personal history of malignant neoplasm codes are Z85.XX. If cancer is not actively being treated, then a “history of” code should be used. ![]()
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