Wiki Pharmacy wants diagnosis to be changed

[dkgrabner@comcast.net]

I work in a SNF and our pharmacy wants us to change a dementia diagnosis with behaviors to dementia without behaviors even thought we CLEARLY have documentation supporting the resident has behaviors. There 'rational' is that the drugs for the dementia do not address the behavioral issues (in this case the behavior is wander). Advice?

 

[SharonCollachi]

The rationale doesn't make sense to me.

Dementia with behaviors or without behaviors, the medication is still for the dementia, correct? Or is he saying it is not covered if there are behaviors also? That's the part that doesn't make sense to me.

 

[dkgrabner@comcast.net]

I believe the statement refers to the fact that the medication does not treat the behaviors so they want me to change the code (which isn't going to happen without documentation)so that it fits their criteria better I'm guessing. I have referred it to our house MD for clarification; let the Phd's duke it out.