Hospice Coding

When coding Unspecified Dementia F0390/F0391 not as a primary DX can these codes be used?

Comments

  • edited April 2017
    Z-codes cannot be primary for hospice. Consult the hospice physician for the residuals of the arrest (anoxic brain damage with respiratory failure is a common outcome) and code first the condition stated as most impacting the patient's terminal trajectory.

    Susan Winokur, HCS-D, BCHH-C | Southwest Medical
    Part of OptumCare
    Senior Medical Coder, Home Health

    8655 South Eastern Avenue, Las Vegas, NV 89123 USA
    T +1 702-838-0644
    Susan.Winokur@optum.com
    smalv.com

    From: Hoyer, Lois [mailto:lhoyer2@Fairview.org]
    Sent: Tuesday, June 28, 2016 1:19 PM
    To: HomeCareCoding-L
    Subject: [homecarecoding-l] Hospice Coding

    I don't code hospice very much. My question is their primary diagnosis is cardiac arrest-I46.9 , coding tips says not to use this code for home health. Can I use the personal history of cardiac arrest Z86.74 as the primary diagnosis for hospice?

    Lois Hoyer RHIT | Coding Analyst Lead
    Fairview Home Care and Hospice
    2450 26th Ave South | Minneapolis MN 55406
    lhoyer2@fairview.org | www.fairview.org
    Office: 612 728 2369 |
    [FVBRND-T]
  • Jeanne

    No, you may not code a neoplasm if it has not been confirmed. If the documentation states a breast lump and probable, carcinoma but patient refuses further testing then the appropriate code would be breast lump or mass. Not neoplasm.

    Hope that helps

    Kathy, CPC

    "Be joyful in Hope,
    Patient in affliction
    Faithful in prayer"
    Romans 12:12
  • edited April 2017
    Coding guidelines in the front of the ICD-10-CM manual state:
    Do not assign a diagnosis documented as "probable," "suspected," "questionable," "rule-out," or "working."

    See page 10 of the 2016 Decision Health coding manual.

    Susan Winokur, HCS-D, BCHH-C | Southwest Medical
    Part of OptumCare
    Senior Medical Coder, Home Health

    8655 South Eastern Avenue, Las Vegas, NV 89123 USA
    T    +1 702-838-0644
    Susan.Winokur@optum.com
    smalv.com

    -----Original Message-----
    From: JEANNE SNYDER [mailto:jeanne.snyder@iroquoismemorial.com]
    Sent: Monday, September 19, 2016 1:47 PM
    To: HomeCareCoding-L
    Subject: [homecarecoding-l] Hospice Coding

    In Hospice if a MD has documented in a progress note that patient has a breast lump right side, likely breast cancer, we cannot code it to a malignancy can we if no biopsies have been done? You cant code a lump to a neoplasm can you can? Please HELP I have an Oncologist saying we can code it to Breast cancer. Thoughts please !!!!!!
  • Thank you for your help!!

    Jeanne Snyder RN
    Intake Coordinator IMH Home Health/Hospice
    200 North Laird Lane
    Watseka,Il. 60970
    815-432-6175/815-432-0185
    FAX 815-432-6199
    jeanne.snyder@iroquoismemorial.com
  • edited April 2017
    I forwarded this question to Judy Adams, who was gracious enough to provide a thorough answer for us, and gave permission to post it to the listserve:

    Susan Winokur, HCS-D, BCHH-C | Southwest Medical
    Part of OptumCare
    Senior Medical Coder, Home Health

    8655 South Eastern Avenue, Las Vegas, NV 89123 USA
    T    +1 702-838-0644
    Susan.Winokur@optum.com
    smalv.com

    -----Original Message-----
    From: Claudette Mercier [mailto:cmercier@vnhsc.org]
    Sent: Thursday, December 29, 2016 12:25 PM
    To: HomeCareCoding-L
    Subject: [homecarecoding-l] Hospice coding

    If MD documents dx of CKD,stage unspec and documents HTN as non-relevant dx, do I still code to I12.9, N18.9? I've been coding it this way but now I'm beginning to wonder if I'm coding correctly, and what if CKD is the primary Dx. These combination codes are confusing when it comes to Hospice's relevant dx vs non-relevant dx.
    Please advise.
    Thank you!
  • edited April 2017
    Yes for Home Health Services, not sure for hospice.
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