Risk Adjustment

HCC Tip Tuesday

From our Director of Coding, here is the HCC Tip of this week:

Updated ICD-10-CM guidelines and Coding Clinic advice (Q2 2016) regarding the use of the term “with” affect not only diabetes mellitus and its complications, but any condition in which the word appears in the index or tabular.

One additionally important change under this guidance relates to hypertension with heart failure. Under previous guidance, hypertension could be assumed to be related to chronic kidney disease; but hypertensive heart disease was required to be documented explicitly by the provider. This is no longer the case under ICD-10 (and is effective from ICD-10’s implementation on date-of-service/date-of-discharge October 1, 2015), in which hypertension and heart failure may now be assumed to be causally related.

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