Certified Risk Adjustment Coder (CRC)

Which condition would be coded with a history of code?

1. Patient with controlled asthma.

2. Patient with a history of MI six months ago.

3. Patient with breast cancer receiving chemotherapy.

4. Patient with a history of HIV.

The correct answer is: Patient with a history of MI six months ago.

The condition that is appropriately coded with a history code is the patient with a history of myocardial infarction (MI) six months ago. In risk adjustment coding, a history code represents conditions that have been treated or have resolved but may still have implications for the patient’s health. Since the patient had an MI six months prior, it indicates that while the event has occurred and is currently not active, it is significant enough that it needs to be documented as it can influence future healthcare management. Coding a history of MI is essential because it can affect the patient's overall health status, potential future care plans, and risk assessment. The healthcare provider needs to be aware of the patient's cardiac history to make informed decisions regarding treatment and follow-up care. In contrast, controlled asthma, ongoing chemotherapy for breast cancer, or a current HIV diagnosis would not typically be coded as a history because they reflect active management of existing conditions rather than a resolved issue.