Wiki Hospice Coding

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pJohnson15

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I'm relatively new to Hospice coding and am wondering if someone can shed some light on this please? How are probable diagnoses coded for Hospice? For example, if it is documented that the patient has probable lung cancer based on the CT finding of a lung nodule, would you code it as cancer or the nodule?

Thank you, Pam
 
I would code the symptoms, so the nodule, and any others there may be, i.e. SOB, Chest pain, etc.

Until they have the definitive diagnosis from a biopsy or some testing, you don't want to assign a diagnosis that the patient doesn't have. It could be biopsied and come back as a benign lesion of the lung.

Many times our providers will list a diagnosis like Diverticulitis, then go on to say probable: differential diagnosis of blah blah blah. So we just code the symptoms.

I had a doctor put that the patient had COPD (that she didn't have, she had some symptoms but not COPD) in her assessment once and she was denied insurance b/c of it (he did not state it as probable). But things like that could affect the patient down the line.
 
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