One worker feels that there must be documented comorbidities that are different than the surgical diagnosis (such as htn, dm, etc), to support p3, p4 and to query the physician if these are missing. And that the surgical diagnosis alone even if a severe diagnosis is not enough to support billing p3 p4 as the anesthesia cpt for that specific severe surgical diagnosis already takes into account of the severity in the base units of the code.
Another worker feels that the surgical diagnosis is enough to support p3, p4 and above if it is a severe systemic disease on its own, like heart valve replacement mitral regurgitation, etc.
Thank you.
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Co morbidity requirements for risk level 3