Q: What are the rules for adding maximum tolerated codes?
The decision to add a maximal tolerated exception code always sits with a clinician and would be decided on a patient by patient basis. The guidance is therapies should be titrated until the target or maximum tolerated dose is reached. If the patient remains out of clinical range, you can add appropriate maximum tolerated codes. Maximal
- Patient on maximal tolerated antihypertensive therapy (CHD 15/16, DM33, HYP08/09, STIA14/15)
- Patient on maximal tolerated lipid lowering therapy (CHOL003/004, DM22/23)
- Patient on maximal tolerated therapy for diabetes (DM20/21)
Do not be afraid to use these codes where appropriate to do so, they demonstrate good quality patient care.