tci Part B Insider - 2022 Issue Q1

Reader Questions: Understand the Nuances of Coding for Chronic Diseases With Exacerbation

Question: Please settle this debate. One of our providers is saying that we should always code chronic conditions as chronic conditions with exacerbation, as chronic conditions always have the capability of exacerbating at any time. However, I believe you can only code a chronic condition as chronic with exacerbation at the time of a visit when the patient is presenting with that exacerbation. Which of us is correct? Nebraska Subscriber Answer: Both ICD-10 and the AMA in the CPT® guidelines for the office/outpatient evaluation and management (E/M) codes view chronic illnesses with exacerbations in the same way: “An...

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