Number and Complexity of Problems Addressed

Question:

I see a number of patients with chronic problems such as dermatitis, psoriasis, history of skin cancer and acne to name a few. What defines stable versus exacerbation or progression?

Answer:

Based on the AMA CPT guidelines a chronic illness is expected to last at least a year or until the death of the patient. You as the practitioner determines when a condition becomes chronic. Of course, there are many conditions that are chronic by the nature of the disease. A stable chronic illness is defined by the specific treatment goals of each individual patient. A patient who is not at treatment goal, not responding to treatment, condition failing to improve, etc. is not stable.

If the patient has a chronic illness with exacerbation, progression or side effect of treatment or inadequately controlled, this would be considered a chronic illness with exacerbation or progression. Typically, a condition exacerbating will require a change or modification in the plan of care. It is important for each problem addressed the practitioner documents the complexity of the problem (stable, chronic, acute, uncomplicated) and the status of the condition (at treatment goal, inadequately controlled, worsening, improving) to paint a clear picture of the condition.

*This response is based on the best information available as of 1/16/25.