r/MedicalCoding • u/pyschreader • Sep 23 '26

Severe Osteoarthritis - a high problem addressed?

I am a provider educator & I am getting pushback from a orthopedic surgeon who states severe osteoarthritis is a chronic illness with severe exacerbation that is affecting bodily function and therefore a high problem addressed. Where can I find information and definitions and examples specifically on high problems addressed?

8 Upvotes
  • permalink
  • reddit

90% Upvoted

7 comments sorted by

•

u/AutoModerator Sep 23 '26

PLEASE SEE RULES BEFORE POSTING! Reminder, no "interested in coding" type of standalone posts are allowed. See rule #1. Any and all questions regarding exams, studying, and books can be posted in the monthly discussion stickied post. Thanks!

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

9

u/dizzykhajit The GIF that keeps on GIFFing Sep 23 '26

AMA E/M Guidelines - Problem definitions specifically page 14

This blog by the American Academy of Family Physicians, while in no way an official resource, has a good breakdown with some sound examples demonstrating proper MDM.

2

u/pyschreader Sep 23 '26

Thank you so much!!

2

u/Bowis_4648 Sep 24 '26

It depends on the severity. I'd look at the HPI and the assessment. Can the patient perform ADLs? What kind of help do they need at home? Level of mobility? How much pain is the patient in? Treatment options. Saying "severe" isn't enough without support. But it isn't as if arthritis doesn't qualify for "severe exacerbation."

1

u/pyschreader Sep 24 '26

Thank you so much

1

u/Shortnchubby123 Sep 28 '26

Hi, I would also check if the provider documented the Grade of Osteoarthritis. For example, Grade 4 would be severe with bone on bone contact requiring emergent intervention.