Certified Risk Adjustment Coder (CRC)

When is a cancer diagnosis coded as current?

1. Patient was diagnosed within the last 5 years with cancer.

2. Patient is receiving active treatment.

3. Patient is documented in remission.

4. Once patient is diagnosed with cancer they are always coded as active.

The correct answer is: Patient is documented in remission.

A cancer diagnosis is considered current when the patient is documented as receiving active treatment for the disease. In the context of risk adjustment coding, this reflects the ongoing management and monitoring of the disease, which are critical for accurately capturing the patient's health status. While a patient diagnosed within the last five years may have ongoing implications, this timeframe alone does not denote that the cancer is active. Similarly, documentation of remission indicates that the disease is not currently active, and therefore, it wouldn’t warrant a current coding for cancer. The idea that once diagnosed, a patient is always coded as active does not align with the guidelines for accurate coding practices, which require that current diagnoses reflect the patient's present health status rather than merely historical data about their condition. Thus, the coding is contingent on the patient's active treatment status, affirming that it is essential to capture the patient's current state accurately for risk assessment purposes.