CCO Admin asked:
Sorry...pressed enter too soon. I am a new coder (six months) in my first job since becoming certified. I am having a difficult time grasping the concept of support or MEAT as my supervisor calls it. She has a background in HCC coding; and we are now doing ProFee; but management also wants us to capture chronic conditions for HCCs; MRA etc. I do not fully understand it since I was not trained in it. Anyway; I have been told I am capturing diagnoses that are not supported. For instance; if the doctor states in the HPI that the patient is following up with a urologist and then gives a diagnosis of bladder cancer; I am reluctant to not code that diagnosis. However; the supervisor says it is not supported. Also; I do not feel comfortable not coding things like diabetes because I feel they affect the entire body and are almost always pertinent. However; if the doctor stated nothing about the diabetes other than including it in the assessment list; I am told that is not supported. Any advice
that would help me understand this topic would be appreciated. If the doctor takes the time to give a diagnosis; does that not mean he has considered it in the overall picture of the patient?
Answer:
Great question; Sandra. Are you familiar with the acronym; MEAT? If not; I will explain it now. The acronym stands for monitor; evaluate; assess; and treat. Supporting documentation can include a wide variety of things such as indicating that the patients condition is stable; worsening; improving; what medication are they on; referrals; etc.
In risk adjustment or HCC; there needs to be supporting evidence that the provider evaluated that condition during the face-to-face visit. If the provider just notates the condition in the assessment with no reference to a treatment plan; how are we to know that they did not copy/paste from the past medical history or from another encounter? Providers should know that they are able to capture any condition that plays a factor in their medical decision making as long as it is correctly documented in the assessment along with an associated treatment plan.
One example that I like to use a lot with providers is when a patient presents to the office with a sinus infection but they also have diabetes mellitus. We know that the provider would need to take into consideration the patients diabetes when selecting the medication or treatment plan as there could be a drug interaction with their diabetes condition/medication. Does this answer your question? If not; please let me know.
Sorry...pressed enter too soon. I am a new coder (six months) in my first job since becoming certified. I am having a difficult time grasping the concept of support or MEAT as my supervisor calls it. She has a background in HCC coding; and we are now doing ProFee; but management also wants us to capture chronic conditions for HCCs; MRA etc. I do not fully understand it since I was not trained in it. Anyway; I have been told I am capturing diagnoses that are not supported. For instance; if the doctor states in the HPI that the patient is following up with a urologist and then gives a diagnosis of bladder cancer; I am reluctant to not code that diagnosis. However; the supervisor says it is not supported. Also; I do not feel comfortable not coding things like diabetes because I feel they affect the entire body and are almost always pertinent. However; if the doctor stated nothing about the diabetes other than including it in the assessment list; I am told that is not supported. Any advice
that would help me understand this topic would be appreciated. If the doctor takes the time to give a diagnosis; does that not mean he has considered it in the overall picture of the patient?
Answer:
Great question; Sandra. Are you familiar with the acronym; MEAT? If not; I will explain it now. The acronym stands for monitor; evaluate; assess; and treat. Supporting documentation can include a wide variety of things such as indicating that the patients condition is stable; worsening; improving; what medication are they on; referrals; etc.
In risk adjustment or HCC; there needs to be supporting evidence that the provider evaluated that condition during the face-to-face visit. If the provider just notates the condition in the assessment with no reference to a treatment plan; how are we to know that they did not copy/paste from the past medical history or from another encounter? Providers should know that they are able to capture any condition that plays a factor in their medical decision making as long as it is correctly documented in the assessment along with an associated treatment plan.
One example that I like to use a lot with providers is when a patient presents to the office with a sinus infection but they also have diabetes mellitus. We know that the provider would need to take into consideration the patients diabetes when selecting the medication or treatment plan as there could be a drug interaction with their diabetes condition/medication. Does this answer your question? If not; please let me know.
Last edited: