# Deceased



## avon4117 (May 14, 2017)

I'm coding discharge summaries and came across one with no dx code but pt is deceased. Is brain death appropriate? It does states patient came in for hypotension. He became hypoxic and started to deteriorating. These dx code are not on the discharge summary. It just shows patient deceased. Thanks for your help.


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## bink1018 (May 15, 2017)

*Death NOS vs Brain Death*

Hello,
Brain death would not be appropriate to code unless the provider specifically documents the patient suffered brain death.  I believe the appropriate code would be R99, Death NOS.   

Barb Williams, BS, CPC, CRC, CCP, AAPC Fellow
Greater Pittsburgh Chapter


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## mitchellde (May 15, 2017)

bink1018 said:


> Hello,
> Brain death would not be appropriate to code unless the provider specifically documents the patient suffered brain death.  I believe the appropriate code would be R99, Death NOS.
> 
> Barb Williams, BS, CPC, CRC, CCP, AAPC Fellow
> Greater Pittsburgh Chapter


Please read the coding guidelines.  It states:
Code R99, Ill-defined and unknown cause of mortality, is only for use in the very limited circumstance when a patient who has already died is brought into an emergency department or other healthcare facility and is pronounced dead upon arrival. It does not represent the discharge disposition of death. 
For a discharge of death you will need the discharge summary to summarize the signs and symptoms a the very least that brought the patient to the facility. 
Yoy cannot code brain death if it is not documented.  It is not up to the coder to decide the manner of death.


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## avon4117 (May 18, 2017)

mitchellde said:


> Please read the coding guidelines.  It states:
> Code R99, Ill-defined and unknown cause of mortality, is only for use in the very limited circumstance when a patient who has already died is brought into an emergency department or other healthcare facility and is pronounced dead upon arrival. It does not represent the discharge disposition of death.
> For a discharge of death you will need the discharge summary to summarize the signs and symptoms a the very least that brought the patient to the facility.
> Yoy cannot code brain death if it is not documented.  It is not up to the coder to decide the manner of death.



I was reading the guidelines in my ICD 10 book and it states Use code R99 only when a patient is pronounced dead upon arrival. Its says do not use this code for the discharge disposition of death. Should I then query the doctor for a more definitive diagnosis?


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