Outpatient Facility Coding Alert

Reader Questions:

Pin the Palliative Care With V66.7, 290.20, 290.21

Question: A patient has advanced dementia. What diagnosis code can we use for a patient receiving palliative care? 

Missouri Subscriber

Answer: The options you can use in this case are:

  • 290.20 (Senile dementia with delusional features)
  • 290.21 (Senile dementia with depressive features).
  • V66.7 (Encounter for palliative care)

Note:  Coding Clinic, Fourth Quarter 1996, originally addressed code V66.7. Coding Clinic, First Quarter 1998, Vol. 15, No. 1, p. 11, provides additional clarification. The latter states that code V66.7 may be used for any terminally ill patient receiving palliative care. Coders should always report it as a secondary code. The principal diagnosis should always be the terminal condition. Coding Clinic further states that coders may report the code when a patient receives aggressive treatment for a terminal condition and, during the encounter, the provider determines that further aggressive treatment is no longer appropriate and initiates palliative care.

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