Persistent mental disorders due to conditions classified elsewhere (294)

Recording patients’ answers when they appear to lack accuracy is confusing. As home health agencies and their staff gear up to implement OASIS-E, some are questioning the value of a certain type of new item. “Most people I have taught [...]

NCD updates criteria, thresholds for hypertensive beneficiaries. On July 2, the Centers for Medicare and Medicaid Services (CMS) announced changes in its national coverage determination (NCD) for ambulatory blood pressure monitoring (ABPM). The decision “reflects CMS’ commitment to continually updating [...]

You may be on the hook for hospitals' billing problems under HHGM. If you think determining an institutional stay for your patients under HHGM will be tricky when Medicare is the payer, just consider how much more difficult it might [...]

Question: In ICD-9, we used to use the 290.x series when the diagnosis was of senile dementia, and we used the 294.1x or 294.2x series for dementia with underlying cause or no specified cause attributed. How do we report dementia under [...]

Some codes missing from CMS’s list may surprise you. Wondering exactly which patients the Centers for Medicare & Medicaid Services thinks should be eligible to receive visits for daily insulin injections? Look no further than the 2015 prospective payment system [...]

Question: Your 52-year-old male patient has been diagnosed with dementia due to early-onset Alzheimer’s. The physician notes that he has been having increasing dementia and forgetfulness. He has been wandering off and leaving his home and forgetting where he is [...]

Question: When reporting a diagnosis of dementia, we are now being told that the diagnosis code, 294.11 will need an underlying condition such as Alzheimer’s or epilepsy. What if the patient does not have any other underlying conditions or if the [...]

Wondering exactly which patients the Centers for Medicare & Medicaid Services thinks should be eligible to receive visits for daily insulin injections? Look no further than the 2015 prospective payment system final rule. Table 34 in the rule outlines the [...]

Question: Our psychiatrist recently diagnosed a patient with dementia. The patient has a history of Alzheimer’s disease. What code(s) should I report for the diagnosis of the patient? Illinois Subscriber Answer: When reporting a case of dementia with an underlying condition (in [...]

Give yourself a manifestation coding refresher to avoid cash flow problems in the new year. Do you know how to sequence codes when the focus of your patient’s care is a manifestation? Make sure you have the guidelines down pat [...]