Template:ICD10 Guideline Como vs Admit: Difference between revisions

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=== When to use [[Comorbid Diagnosis]] vs [[Admit Diagnosis]] or neither ===  

*Dx was present in the past but that problem is '''resolved''' AND does not fit into one of the [[:Category: Past medical history]] codes

**To be clear on this -- do NOT code past problems that are fully resolved unless they are one of the [[:Category: Past medical history]] codes

* Do not code diagnoses that occur during this admission as a comorbid diagnoses.  If they have completely resolved then do not code as a comorbid diagnosis until the next admission if applicable. ie. surgical ward had a COVID pneumonia resolved prior to ICU admission.  Do not code [[Past history of Covid-19 infection]] until the next hospital admission.  

 

{{ICD10 Guideline Stroke resolved exception}}

{{Ex |*Patient had the left lung removed 7 years ago. Dont code the removal of the lung CCI, but instead code '''[[Past history, removal of all or part of lung]]'''

*For someone who had a [[Cardiac arrest]] in the past, don't code that as a [[Comorbid Diagnosis]] in future admissions, but instead DO code the cause of the cardiac arrest, e.g. an arrythmia, or coronary artery disease, etc.

*Patient has hypertension for which she takes medications and it is well controlled, but not related to the reasons for admission. '''Code this''', because even if not part of the reason for the current admission, the hypertension IS relevant to this person's chronic medical situation and thus SHOULD be coded, as a [[Comorbid Diagnosis]].

*Patient had [[ARDS (noncardiogenic pulmonary edema)]] a few years ago, and while ARDS is only an acute problem and thus is no longer active, his lungs never fully recovered and he has [[Respiratory failure (insufficiency), chronic]] which should be coded as a [[Comorbid Diagnosis]].

*Chronic and ongoing old conditions should be coded -- as a [[Comorbid Diagnosis]] if not part of the reason for this admission. }}

==== Some diagnoses can/should be coded as BOTH [[Admit Diagnosis]] and [[Comorbid Diagnosis]] ====

If a dx is chronic but also actively treated during this admission, code it as both [[Admit Diagnosis]] and [[Comorbid Diagnosis]].

{{Ex |  

* ex1: Patient who has been, and still is, being treated for active pulmonary TB as an outpatient, and is admitted for an acute MI.  Here since on the current admission the TB is still being actively treated, it qualifies as an [[Admit Diagnosis]], as above.  But because it has been present from long before this admission, it also qualifies as an "active" [[Comorbid Diagnosis]].

* ex2: Patient has a past history of CHF and thus it should be coded as a [[Comorbid Diagnosis]]. And if the CHF is worse at admission and it is part of the reason for admission, then CHF should also be an [[Admit Diagnosis]].

}}

==== Recurrent conditions ====

* Do '''not code''' a recurrent condition that is NOT currently present -- if currently active, include as [[Admit Diagnosis]], otherwise don't code it

{{Ex |

* Ex1: Recurrent pneumonia -- in between the infections, there IS NO pneumonia}}

{{Ex |* Ex2: [[Asthma, without acute exacerbation]] -- this '''is'' a chronic disease whose nature is intermittent symptoms, but in between those symptoms the person still has asthma.}}

=== [[Controlling Dx Type for ICD10 codes]] ===

This wiki page talks about which ICD10 codes are ''allowed'' to be [[Comorbid Diagnosis]] vs. [[Admit Diagnosis]] vs. [[Acquired Diagnosis]] [[Dx Type]]. See [[Controlling Dx Type for ICD10 codes]] for a discussion about cross-checks for these.

| always= see how this used to be coded...

| full=

*As of June 25, 2020, the rules were revised for coding as [[Comorbid Diagnoses]] those diagnosed during the current hospitalization (either at admission or thereafter) but which virtually certainly were present pre-admission.