Yes, you do. The medical record is a legal document that must reflect all the conditions the patient has and their management.  If the patient has all three conditions, and they are properly assessed and documented, they must all be reported.

From a purely payment standpoint, consider that the CMS-HCC payment methodology is subject to change and there exists the possibility that HCCs could be split, or conditions may be dropped from the model.

In addition, regulatory efforts have increased and health plans are more aggressively reviewing documentation and disallowing conditions that don’t pass muster.  If you only reported one of the conditions because it’s in the same HCC as the others, and that dx isn’t properly supported on the note, the code could be removed.  If the reporting period has already closed, you might not be able to resubmit the other codes for payment.

If the provider has ‘cut corners’ in documentation to supposedly save time, this could impact the funding. As a coder, you should report everything documented by your clinician, regardless of the HCC.

p.s.  Remember that PVD & athero of LE contain an Excludes1 message: you can’t code them both at the same visit.