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Question: I鈥檓 new to coding and am having trouble finding information as to when I should assign a code for an acute condition versus a chronic one in the ICD-10-CM Official Guidelines. Can you help me?

Minnesota Subscriber

Answer: Indeed, the ICD-10-CM Official Guidelines don't explicitly distinguish between acute and chronic conditions. Let鈥檚 take a look at Section I.B.8 for more details: 鈥淎cute and Chronic Conditions鈥� does explain how to sequence conditions that are described as both acute (subacute) and chronic. When a condition is characterized as both acute and chronic, and separate codes exist in the Alphabetic Index at the same indentation level, you should allocate both codes, prioritizing the acute code first.

There isn鈥檛 a definitive timeframe for what makes a condition 鈥渃hronic.鈥� For example, the Centers for Disease Control and Prevention (CDC) describe chronic conditions as those that persist for one year or longer (). The AMA CPT^庐 guidelines for evaluation and management (E/M) coding lists a stable, chronic illness as 鈥淎 problem with an expected duration of at least one year or until the death of the patient.鈥�

Ultimately, the classification of a condition as acute or chronic will depend on your provider鈥檚 determination. If your provider鈥檚 documentation specifies acute or chronic, that will guide your code assignment. If it doesn鈥檛, you may need to query the provider for further information.

Lindsey Bush, BA, MA, CPC, Development Editor, AAPC