Wiki Hospice coding

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mlg_30@yahoo.com

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Hi I am new to the world of Hospice coding and I was hoping to connect with someone who has been working in the field. I am in need of clarification and direction with ICD10 codes needed to satisfy the requirements set forth.
Anyone feel like assisting me?
 
Ok, so this is in regards to the paragraph I pasted here, the Final Rule from Aug 2015.
We are having difficulties agreeing on what diagnosis this means. Every single thing? or Just anything that pertains to their coming on hospice?
currently, we gather our information from their most recent h&p as well as our initial exam.
What is your process?

Clarification Regarding Diagnoses on Claim Form
We are clarifying that hospices are required to report all diagnoses identified in the initial and comprehensive assessments on hospice claims, whether related or unrelated to the terminal prognosis of the individual. ICD-9-CM coding guidelines (and effective on October 1, 2015, ICD-10-CM) state to report all diagnoses that affect patient care. This also includes the reporting of any mental health disorders and conditions that would affect the plan of care, as hospices are to assess and provide care for identified psychosocial and emotional needs, as well as for physical and spiritual needs.
 
By our understanding (myself, my Executive Director, and my QAPI nurse) we are to code every CURRENT diagnosis. I code the primary hospice diagnosis first, followed by anything related to that or co-morbids that affect the POC, followed by all other current diagnosis; no "history of" codes. I am gathering my info from the initial exam as well as most recent H&P. You have to be careful in the H&P to make sure it's a current diagnosis and not just mentioned as history but resolved.

Hope that helps!
 
I am trying to figure this out as well and have been looking for some help. I am so new at coding and have been doing some diagnosis coding for hospice. I am hoping but may not be doing some things the right way. I have been coding some of the history of in the cases of things like secondary malignancy as primary diagnosis when the primary cancer site is no longer there. I hope this is right. I have been coding a history of DVT etc if they are still receiving a medication like Coumadin directly related to the history. The thing that is confusing me most and I have been getting conflicting information on is CVA. I am told we cannot use CVA in hospice but must use a sequela of. The patients that suffer a massive CVA and are close to or are unresponsive I want to code a sequela but not sure which one, Cognitive deficit ? Still learning the guidelines but seem hard to apply to hospice at times. Any help would be appreciated!! :)
!!
 
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