Posts tagged ‘comorbidity’

November 29, 2010

A comorbidity quandry? No, look at treatment and patient health

I continue to receive questions on hypertension (401.9) and pulmonary hypertension (416.0). One reader recently asked if I would consider pulmonary hypertension to be a comorbidity that should always be coded.

Remember that the list of comorbidities “that should always be coded” are examples of diagnoses likely to impact care because of the chronicity. When you code a comorbidity … a condition that affects the patient’s health, or is such an impactful disease that even if it is under control can affect the patient’s health detrimentally and quickly … that you must think about the treatment aspect.

Is pulmonary hypertension under treatment with medications, education, or intervention? Yes, code it. Does pulmonary hypertension have the potential of impacting other conditions? Probably, but remember that CMS requires that comorbidities be addressed in the POC, so what are you doing about the pulmonary hypertension?

Keep in mind that “chronic” does not automatically mean that a disease is a comorbidity. GERD (530.81) is a great example. A patient may have chronic GERD, but if medication has taken care of symptoms for a length of time, what justifies its “status” as a comorbidity? It’s not being treated by home health professionals. There aren’t interventions.

I love this question … someone is thinking on their feet!

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July 17, 2010

HTN on the case-mix chopping block

A part of the HHPPS payment adjustment for 2011 includes a proposal to remove 401.9, Unspecified Essential Hypertension, and 401.1, Benign Essential Hypertension, from the case-mix list because an analysis shows that patients with these diagnoses don’t use more resources than other patients. This is a huge change, as HTN is an accepted comorbidity that is always coded because it can influence a patient’s health and resource usage.

Read more in the document here, and keep looking on this blog for more news as I review the whole document and post more information.

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