DIAGNOSIS CODING ESSENTIALS FOR LONG-TERM CARE: CHAPTER 5, F CODES MENTAL, BEHAVIORAL AND NEURODEVELOPMENTAL DISORDERS Preferred Clinical Services for Leading Age Florida August 26-27, 2015 IMPORTANT Codes in this chapter include disorders of psychosocial development but exclude symptoms, signs and clinical laboratory finding (R00-R99)
All claims submitted for services ON or AFTER October 1stmust have ICD -10 codes only. Most residents will require dual coding THE CHALLENGE
CODING GUIDELINES Acute and Chronic Conditions If the same condition is described as both acute (subacute) and chronic and separate subentries exist in the Alphabetic Index at the same indentation level, code both and sequence the acute (subacute) code first. Acute and Chronic Renal Failure
Diagnostic coding plays several important roles in every healthcare setting, including long-term care (LTC) nursing facilities. Come October 1, 2015, LTC facilities will assign ICD-10-CM codes to capture a resident's clinical conditions. ICD-10-CM facilitates the collection and....
The 2022 edition of ICD-10-CM Z74. 1 became effective on October 1, 2021. This is the American ICD-10-CM version of Z74.
Y92.12ICD-10 Code for Nursing home as the place of occurrence of the external cause- Y92. 12- Codify by AAPC.
ICD-10 code Z71. 89 for Other specified counseling is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
Z51.5Z51. 5 - Encounter for palliative care | ICD-10-CM.
1 - Person awaiting admission to adequate facility elsewhere.
ICD-10 code Z51 for Encounter for other aftercare and medical care is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
The patient's primary diagnostic code is the most important. Assuming the patient's primary diagnostic code is Z76. 89, look in the list below to see which MDC's "Assignment of Diagnosis Codes" is first.
89.
CPT Code 99205 OFFICE OUTPATIENT NEW 60 MINUTES Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity.
The HCPCS codes range Palliative Care Services G9988-G9999 is a standardized code set necessary for Medicare and other health insurance providers to provide healthcare claims.
Answer: Yes, assign code Z51. 5, Encounter for palliative care, as principal diagnosis when palliative care is documented as the reason for the patient's admission.
Palliative care is specialized medical care for people living with a serious illness. This type of care is focused on providing relief from the symptoms and stress of the illness. The goal is to improve quality of life for both the patient and the family.
Associated conditions (overweight, obesity, or pressure ulcer) must be documented by the patient’s provider. If there is conflicting medical record documentation, either from the same clinician or different clinicians, the patient’s attending provider should be queried for clarification. CODING GUIDELINES .
B95 Streptococcus, Staphylococcus, and Enterococcus as the cause of diseases classified elsewhere B96 Other bacterial agents as the cause of diseases classified elsewhere B97 Viral agents as the cause of diseases classified elsewhere . Instructional note advises that an additional organism code is required .
According to Coding Clinic, “when a patient is admitted to the LTC facility specifically for rehab following an injury, assign the acute injury code with the appropriate 7th character as the first-listed diagnosis.”
Initial treatment of a disease has been performed and the patient requires continued care during the healing or recovery phase, or for the long-term consequences of the disease.
Status Z codes may be used with aftercare Z codes to indicate the nature of the aftercare or to indicate the surgery for which the aftercare is being performed Example:
Z20 -Residents who do not show any signs or symptoms of a disease but are suspected to have been exposed to it by close personal contact or are in an area where a disease is epidemic.
When the reason for the admission is strictly for convalescence and there is no other definitive diagnosis, assign code Z51.89, Encounter for other specified aftercare, as the first-listed diagnosis.
The reason for the LTC admission is to allow the patient to regain strength and the fracture to heal. What code is used to describe the LTC admission?
In this case, if the patient is in the recovery phase equal to, or less than, the four-week time frame for the acute myocardial infarction (AMI), continue to use code I21.19, ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall. Please note that for encounters occurring while the myocardial infarction is equal to, or less than, four weeks old, including transfers to another acute setting or a postacute setting, and the patient requires continued care for the myocardial infarction, codes from category I21 may continue to be reported. However, if the AMI occurred more than four weeks before, assign code Z51.89, Encounter for other specified aftercare.
A nursing home resident fell and was transferred to the hospital for treatment of a left wrist fracture. After inpatient surgical treatment of the fracture, he is returned to the nursing home where he has resided for several years due to Alzheimer’s disease. The patient will receive occupational therapy at the nursing home, but the therapy is not the primary reason for the nursing home admission. How should this be coded?
Assign code N39.0, Urinary tract infection, site not specified. The diagnosis would be part of the resident’s active problem list until the infection is resolved, at which time it would no longer be coded and reported.
A nursing home resident is transferred to the hospital for treatment of pneumonia. She returns to the nursing home and is still receiving antibiotics for the pneumonia. However, the main reason she is returning to the nursing home is because this has been her residence since developing a CVA with residuals several years ago. Which diagnosis should be listed first at the nursing home, the pneumonia or late effects of the CVA? Would it make any difference if the pneumonia was no longer receiving any treatment upon the resident’s return to the nursing home?
Assign code I69.354 , Hemiplegia and hemiparesis following cerebral infarction affecting left nondominant side, and code I69.321, Dysphasia following cerebral infarction, to completely describe the patient’s condition. The hemiparesis and dysphasia are considered sequelae of the acute CVA for this LTC admission. Coding guidelines state that these “late effects” include neurologic deficits that persist after initial onset of conditions classifiable to categories I60-I67. Codes from I60- I67 are reserved for the initial (first) episode of care for the acute cerebrovascular disease. Please refer to the 2013 edition of the coding guidelines for guidance as to the use of dominant/nondominant side for codes from category I69.