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]
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
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 !!!!!!
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!
Comments
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]
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
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 !!!!!!
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
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!