Comorbid Diagnosis: Difference between revisions

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''For other diagnoses we collect see [[Admit Diagnosis]] or [[Acquired Diagnosis / Complication]].''

'''Comorbid Diagnoses''' are for diseases the patient has had for some time. Comorbidities can be a factor in increasing the patient risk of dying; see [[Charlson Comorbidity Index]].

'''[https://en.wikipedia.org/wiki/Comorbidity Comorbid Diagnoses]''' are for diseases the patient has had for some time. Comorbidities can be a factor in increasing the patient risk of dying; see [[Charlson Comorbidity Index]]. A Comorbid Diagnosis is coded by setting the [[Dx_Type]] to "comorbid".

== Collection Instructions ==

*Many ICD10 diagnosis code ~~can be used as~~ a ~~comorbid/pre-existing diagnosis -- the general criterion~~ is ~~that it~~ was present ~~PRIOR~~ to admission ~~AND~~ is ~~still present~~ and ~~clinically relevant.~~

==== When to code a [[Comorbid Diagnosis]] ====

**~~If the diagnosis under consideration qualifies as an~~ '''[[~~Admit~~ Diagnosis]]''', ~~then in general it is not appropriate to code it~~ as ~~a comorbidity.~~

*'''Either''':

**~~If the diagnosis is acute then in general it is not appropriate to~~ code it as a ~~comorbidity.~~

**Dx is '''chronic''' and was present and known '''prior''' to admission, even if it was only discovered during this admission

*Code these even if ~~the diagnosis of the condition was only made~~ during the current ~~hospital~~ admission ~~but it is quite clear that it must have existed before admission (even if that wasn~~'~~t known~~).

**Dx is in the past and is resolved and is included in one of the: [[:Category: Past medical history]] codes

**~~Example 1: If a patient is admitted with pneumonia and~~ on ~~further workup is found to have CA of the lung, then this is coded in comorbid~~ as it is ~~obvious that the cancer must have been there for a while prior to~~ admission.

**Dx is '''chronic''' and '''was not known prior to admission'''

**Example 2: Patient comes in with ~~abdominal pain~~. Diagnosed as gastroenteritis but incidentally pt is found to be HIV +ve. You would code HIV +ve as a comorbid. Again, this is obvious that the pt had this problem for a while prior to admission to the hospital.

***In this situation, code it as a [[Comorbid Diagnosis]] if it is a chronic, '''non-infectious''' condition -- e.g. a cancer, collagen-vascular disease (such as [[Systemic lupus erythematosis (SLE, lupus)]]), COPD, diabetes

***But do NOT code it as [[Comorbid Diagnosis]] if it is a chronic '''infectious''' condition -- such as [[Tuberculosis]] or [[AIDS (disease due to HIV)]] (which if first discovered/identified during the current admission ''would'' qualify as an [[Admit Diagnosis]]).

***Note that this rule does not impact on coding as a [[Comorbid Diagnosis]] an infection which is still present but WAS known pre-admission --- e.g. an osteomyelitis being treated at home with iv antibiotics.

=== ~~Past medical history~~ ===

=== signs and symptoms should not be code as comorbidities ===

~~There is~~, ~~in ICD10~~, ~~a small list of codes that represent previous ''procedures''~~ or ~~medical situations that can't~~ be ~~captured in another way -- '''[[:category:Past medical history]]'''~~

*Signs, symptoms and findings (e.g. chest pain or dyspnea, or abnormal LFTs) should NOT be coded as comorbidities. Only real specific diagnoses should.

=== ~~Priorities~~ ===

=== Patient has no comorbidities ===

~~You will need to~~ enter ~~priorities for comorbids to group them for~~ [[~~Combined~~ ICD10 ~~codes~~]]~~. Don't worry about actually prioritizing them, for comorbids the priorities will only be used for grouping~~.

If a patient has no comorbidities, enter [[No Comorbidities (ICD10 code)]].

=== ~~Patient has no comorbidities~~ ===

=== [[Dx_Priority]] ===

~~If a patient has no comorbidities,~~ enter [[~~No Comorbidities (~~ICD10 ~~code)~~]].

'''You will need to enter priorities for comorbids'''. For comorbids the priorities will only be used for grouping [[Combined ICD10 codes]], not for prioritizing them in any order of importance.

== Transfer of Comorbids on transfer between wards ==

{{~~DiscussTask|~~

See [[Patient copier button]] for more.

* Hi Tina is there any way that our comorbid diagnosis in the NEW ICD 10 collection can be transferred with the patient when they are discharged to another ward rather than readmitting and entering them ? (Shirley)}}

===Related articles ===

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[[Category: ICD10]]

[[Category:ICD10]]

[[Category: Comorbid]]

[[Category:Comorbid]]

[[Category: Diagnosis Coding | *]]

[[Category:Comorbid Diagnosis | *]]

[[Category: Comorbid Diagnosis | *]]

[[Category:ALERT Scale Elements]]

[[Category: ~~MOST Score~~ Elements]]

[[Category:Data Collection Guide]]

[[Category: Data Collection Guide]]

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 ''For other diagnoses we collect see [[Admit Diagnosis]] or [[Acquired Diagnosis / Complication]].''
-'''Comorbid Diagnoses''' are for diseases the patient has had for some time. Comorbidities can be a factor in increasing the patient risk of dying; see [[Charlson Comorbidity Index]].
+'''[https://en.wikipedia.org/wiki/Comorbidity Comorbid Diagnoses]''' are for diseases the patient has had for some time. Comorbidities can be a factor in increasing the patient risk of dying; see [[Charlson Comorbidity Index]]. A Comorbid Diagnosis is coded by setting the [[Dx_Type]] to "comorbid".
 == Collection Instructions ==
-*Many ICD10 diagnosis code can be used as a comorbid/pre-existing diagnosis -- the general criterion is that it was present PRIOR to admission AND is still present and clinically relevant.
+==== When to code a [[Comorbid Diagnosis]] ====
-**If the diagnosis under consideration qualifies as an '''[[Admit Diagnosis]]''', then in general it is not appropriate to code it as a comorbidity.
+*'''Either''':
-**If the diagnosis is acute then in general it is not appropriate to code it as a comorbidity.
+**Dx is '''chronic''' and was present and known '''prior''' to admission, even if it was only discovered during this admission
-*Code these even if the diagnosis of the condition was only made during the current hospital admission but it is quite clear that it must have existed before admission (even if that wasn't known).
+**Dx is in the past and is resolved and is included in one of the: [[:Category: Past medical history]] codes
-**Example 1: If a patient is admitted with pneumonia and on further workup is found to have CA of the lung, then this is coded in comorbid as it is obvious that the cancer must have been there for a while prior to admission.
+**Dx is '''chronic''' and '''was not known prior to admission'''
-**Example 2: Patient comes in with abdominal pain.  Diagnosed as gastroenteritis but incidentally pt is found to be HIV +ve.  You would code HIV +ve as a comorbid.  Again, this is obvious that the pt had this problem for a while prior to admission to the hospital.
+***In this situation, code it as a [[Comorbid Diagnosis]] if it is a chronic, '''non-infectious''' condition -- e.g. a cancer, collagen-vascular disease (such as [[Systemic lupus erythematosis (SLE, lupus)]]), COPD, diabetes
+***But do NOT code it as [[Comorbid Diagnosis]] if it is a chronic '''infectious''' condition -- such as [[Tuberculosis]] or [[AIDS (disease due to HIV)]] (which if first discovered/identified during the current admission ''would'' qualify as an [[Admit Diagnosis]]).
+***Note that this rule does not impact on coding as a [[Comorbid Diagnosis]] an infection which is still present but WAS known pre-admission --- e.g. an osteomyelitis being treated at home with iv antibiotics.
+{{ICD10 Guideline Como vs Admit}}
-=== Past medical history ===
+=== signs and symptoms should not be code as comorbidities ===
-There is, in ICD10, a small list of codes that represent previous ''procedures'' or medical situations that can't be captured in another way -- '''[[:category:Past medical history]]'''
+*Signs, symptoms and findings (e.g. chest pain or dyspnea, or abnormal LFTs) should NOT be coded as comorbidities.  Only real specific diagnoses should.
-=== Priorities ===
+=== Patient has no comorbidities ===
-You will need to enter priorities for comorbids to group them for [[Combined ICD10 codes]]. Don't worry about actually prioritizing them, for comorbids the priorities will only be used for grouping.
+If a patient has no comorbidities, enter [[No Comorbidities (ICD10 code)]].
-=== Patient has no comorbidities ===
+=== [[Dx_Priority]] ===
-If a patient has no comorbidities, enter [[No Comorbidities (ICD10 code)]].
+'''You will need to enter priorities for comorbids'''. For comorbids the priorities will only be used for grouping [[Combined ICD10 codes]], not for prioritizing them in any order of importance.
 == Transfer of Comorbids on transfer between wards ==
-{{DiscussTask|
+See [[Patient copier button]] for more.
-* Hi Tina is there any way that our comorbid diagnosis in the NEW ICD 10 collection can be transferred  with the patient when they are discharged to another ward rather than readmitting and entering them ? (Shirley)}}
+{{Data Integrity Check List}}
 ===Related articles ===
@@ Line 28: / Line 32: @@
-[[Category: ICD10]]
+[[Category:ICD10]]
-[[Category: Comorbid]]
+[[Category:Comorbid]]
-[[Category: Diagnosis Coding | *]]
+[[Category:Comorbid Diagnosis | *]]
-[[Category: Comorbid Diagnosis | *]]
+[[Category:ALERT Scale Elements]]
-[[Category: MOST Score Elements]]
+[[Category:Data Collection Guide]]
-[[Category: Data Collection Guide]]