When a patient is in the hospital with acute on chronic respiratory failure or acute on chronic heart failure, when they come to home care do we code acute on chronic or just chronic?
needs to be specified by MD
differentiating/diagnosing between an acute or chronic condition is not within a RN's scope of practice.
I would ask clinician to call MD to specify, or if you are a RN, you could call MD and take order and note it in patient's medical record. As a reviewer, I do that all of the time, when I can't get clinicians to call MD's and I need to get cases off my screen.