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.
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.
Regular comorbid rules exception: Strokes (of any sort, ischemic or hemorrhagic) -- code even resolved strokes with no current sequelae as comorbid diagnoses. If a patient has a past history of stroke, use the regular stroke codes to identify this, even if the patient does not have any residual deficits we will now capture ANY past history of stroke. This is contrary to the usual rules about Comorbid_Diagnosis#When_not_to_code_a_dx_at_all.
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.
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
Example:
Ex1: Recurrent pneumonia -- in between the infections, there IS NO pneumonia
Do code conditions that by nature have intermittent rather than continuous symptoms, but where the underlying condition doesn't go away.
Example:
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.
Past medical history
Past medical history codes
Past medical history codes should only be captured as Comorbid Diagnoses that represent previous procedures or medical situations. Their names usually follow the pattern "Past history of X" or "X, has one". See Category:Past medical history for a list.
Legacy - did not use to code Comorbid Diagnoses only discovered during this admission
see how this used to be coded...
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.
Priorities
You will need to enter priorities for comorbids to group them for Combined ICD10 codes. Don't worry about actually prioritizing them in any order of importance, for comorbids the priorities will only be used for related grouping.
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)
This question has come up in the past and there are unresolved questions at Patient copier button. All collectors, please contribute there... Ttenbergen 09:24, 2018 June 19 (CDT)
