Cracking the Code

Acute and Chronic Conditions

When both an acute and a chronic condition are documented, and there is a separate code for each, we would report both codes. As per the ICD-10-CM guideline I.B.8, the acute (subacute) code is sequenced first. For example, the patient is diagnosed with acute and chronic cystitis. In the ICD-10-CM Alphabetic Index, look for Cystitis. There is a sub-term for acute (N30.00) and a sub-term for chronic (N30.20). The acute code is sequenced first: N30.00, Acute cystitis without hematuria, N30.20, Other chronic cystitis without hematuria. Chronic conditions treated on an ongoing basis may be coded as many times as required for treatment and care of the patient, or when applicable to the patient’s care plan. Do not code conditions previously treated, or those that no longer exist.

Q: When a patient presents with an acute exacerbation of a chronic condition, and no single code captures both the chronic and acute nature of the illness, how are the ICD-10-CM codes sequenced?
A: Code the acute condition first, followed by the chronic condition. Rationale: ICD-10-CM guideline I.B.8, states to code the acute condition first, followed by the chronic condition.
Reference: 2024 ICD-10-CM codebook & guideline I.B.8
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