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Chronic versus acute diagnosis coding, this is actually someone posted on Facebook. They wanted to clarify, what if the patient was diagnosed by 491.0 which is chronic bronchitis and 466.0 which is acute bronchitis. Which one will be primary? We have a poll, maybe we can finish out with a nice poll to see what you guys think. Which do you think would be sequenced first? The chronic bronchitis or the acute bronchitis? Speaking of bronchitis, I probably have it.

Chronic versus Acute Diagnosis Coding- VIDEO

That’s the wrong one, Boyd. Sorry.

Alicia: Yeah, we skipped to that one.

Laureen: There are so many characters. Maybe we didn’t get that one up there.

Alicia: No, that was one that I had put in there earlier. We can do it.

Laureen: There we go. So which do you think will be sequenced first, chronic bronchitis or acute, if the patient had both?

Boyd: 50% voted.

Laureen: Yay, people are still awake, 90 minutes into the call.

Boyd: Thank you guys for staying with us this whole time.

Laureen: I’m showing, I think, 161 are still on at the end. Amazing.

Boyd: Yeah, it’s great.

Laureen: I’m surprised they didn’t hang up when I started hacking away.

Alicia: No, they were looking at their code books trying to figure out how to code what you had. Now they know, bronchitis.

Boyd: If there’s anything that I’ve learned over the years, it’s content that matters. Not necessarily the presentation sometimes.

Laureen: Gee, thanks.

Boyd: 5, 4, 3, 2, 1, closing the polls and sharing the poll.

Laureen: Okay good. So 29% said chronic, 71% said acute. So I’m going to show you how I figured the answer out. It is acute. So looking at the codes here, we’ve got the 466.0 is the acute bronchitis and 491.0 is the chronic. Go to your guidelines for ICD. I should have given Alicia this question. It says, “Acute and chronic conditions: if the same condition is described as both acute and chronic and separate subentries exist in the alphabetic index at the same indentation level then you can code both and sequence the acute code first.” So that’s right from the guidelines. So we need to look at the index and see if the acute subentry and the chronic subentry are at the same level. So I took this from Supercoder and here’s bronchitis. And then indented is acute and then down here is chronic. They are indeed at the same level so the guidelines tell us that we should do the acute first.

And I also included, from the Coding Clinic which is basically the “go to” official resource for ICD, they further clarified that when a particular condition is described as both, whenever separate subentries are listed in the… you sequence the acute condition first. So that was pretty much how did that research. So if you have a good tool like Supercoder, it makes it real quick.

Alicia: And as a general rule, it is.. it usually is acute goes first. I mean, if you have to guess , I would go with acute first. I always remember it as if you’re acute, you always get to the first of the line.

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Chronic versus Acute Diagnosis Coding — VIDEO

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2017-02-17T15:31:16+00:00

About the Author:

Laureen Jandroep
CPC, COC, CPPM, CPC-I.,Sr. Instructor for CCO.us. Resides in southern New Jersey with her husband of over 20 years Anthony and four children. They are active parents and spend most of their time these days just being parents which they love.

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