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Under Review Sequencing of Chronic vs. Acute Diagnosis Coding

ChandralekhaB_82069

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Laureen
Start date (Original date)
Oct 5, 2024 (Feb 19, 2013)

Question from Facebook Discussion Group:

Just wanna clarify this. What if the patient has diagnosed by J02 and J31.2 which one will be the primary code?

Ok first the codes courtesy of supercoder:

AD_4nXcp6466vmrIkIKhV1mYVJ_vC_nkHMghux-zXhLLb838zOa_xQkkTVmIc9AWpA-IbXT9JVKiMeass6Lxf-SGBkTQW9seGcgo_8OjWB_MylFlmh447SORHZNFsREju2tdPqRDYitqk4To7cXwWQRWTErMsELp

AD_4nXeJZuiC4mic5HmOjAg5qKj-Xb_4xOZq44Cgd1znzefEEFgBrkPsXQgrRYqq2vygGPzsK2N15vSha2JJCiBG4d7uzxNd-ZYDu3SaDRyZoyCXf1XoSrVmjnPI1VI4pka_o1djm6M83l6QI_jZRwmoRS_78vo


The official ICD-10 guidelines say
AD_4nXduLqw36vGgrDMmby9ApGgMhALv89sOhQtw1fObL_89fsc_aZVRpPCzHc7ADCT4xcJCNpiCP9zLg9sByUpScEqn3sZxHICHkxwnYBnJ9l6k1KX3R5ca5EdBJBKNGeqikIlM4iw001kciMM7M1IbbE4FjopI


In looking up bronchitis in the index we see that acute and chronic are both listed as sub-terms at the same level so we are good to code both.

AD_4nXdP_LUNG4PMrihOZF5tKJy_x-9o8eRxBztAtR6iz2QPtT9eeAbaYHVWp82YBXdotySArLck-7GmFdZxedpPr7XrJUEKxQ6zErNCcO9r8M1OlwqeZIULm1iDxq79dL9_iW5QBHiSS9VC76NY1jaNwyQIxye1

AD_4nXeTWnWrv3wdqJv0VgmQiBb9tE4xMsZZitmi1BedyIvbicooVehqUkEIOz6Jt7MIzrJrzTgFKNw-Yphajd42PJc6EUMxD158cTVUik1XnckA9rrnMu7dVcQ23yoTHURrfl5bSBmcQSkGuXFetGtLtYYyJ5UL


And this is from the Coding Clinic:
Acute and Chronic Condition

When a particular condition is described as both acute or subacute and chronic, code according to the Alphabetic Index subentries (including those enclosed in parentheses) for that condition, such as:
· Whenever separate subentries for acute (subacute) and chronic are listed, code both and sequence the acute condition first.
· When there are no subentries for acute (subacute) or chronic, disregard these modifiers in coding the particular condition.
· When the Index does not provide a subentry for a condition described as subacute, code the condition as acute.

So in your case the acute would be sequenced first.
 
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