HCC of CAD/angina

bevmo49

We have just started an outpatient CDI @ our facility. Question in regards to the HCC Angina Pectoris. If a patient also has CAD and angina it then becomes a combination code. However, when is it appropriate for the provider to  document  and use the code for CAD with angina. For example, does the pt have to be having active angina or does a  "history of angina" pt currently prescribed Imdur/Nitrostat prn justify the code I25.119 

Our providers are reluctant to use the code CAD with angina unless they are actively having angina on the day of the office visit or recent to the visit.

lprescott1

This is an interesting question. I see this code being applied for those patients who experience chronic stable angina or chest pain that happens when the heart is working hard and requires more oxygen, such as during stress or exertion. The pain diminishes when the patient rests.  The pattern of chest pain is usually consistent, as to how much physical exertion will trigger it. these patients are usually treated with the goal of preventing episodes with medications (aspirin, nitrates, beta blockers, statins, Ca channel blockers etc). and lifestyle changes. i have never experienced an issue with providers not documenting it when there was a history documented and there treatments in place to prevent episodes. It is a chronic condition and if well managed the patient likely will not be experiencing chest pain on the specific visit.