Resolved CRC

[CarliC_71283]

If a risk code can be picked up from hospital visit, consult, or patient visit with PCP anytime during the year and the note is signed.. would risk code repopulate during the same year (even if disagree to it on an earlier date of the same year? I guess I’m asking if a doc disagree to a code, is that “that’s it” for the year? Meaning are they now allowed to change their mind later and must wait next year?

 

[Alicia]

I think I understand Carli. The HCC only has to be captured once a year with MEAT. So an extreme example would be:
Inpatienct code added to problem list of HIV. PCP comes back and states that is not accurate. The pt was exposed to to HIV. The HIV code is documented with MEAT it is stuck with that pt for the year in the RAF score.

Now, let's say DM /c CKD. The Inpatient code E11.9, N18.30 but the PCP knows it is E11.22, N18.30. This is corrrected by the auditors and would not matter. Note E11.9 = 19 HCC and E11.22 = 18 HCC which will raise the RAF score.

Let me know if this helps. Feel free to give an example of dx.