So it really depends on the documentation but eother can be used as a primary diagnosis.
#ICD 10 CODE ALTERED MENTAL STATUS CODE#
"We believe that by the time an individual is admitted to home health, the patient has been seen by other health care providers and a diagnosis has been established,” CMS stated in the Final Rule. Altered mental status and altered state of consciousness are two different things which is why the 780.97 code excludes the 780.01-780.09 codes. "In the case of gait abnormalities, for example, a patient whose gait abnormalities are due to neurological issues would be expected to have a completely different care plan from a patient whose gait abnormalities are due to fractures or some type of traumatic injury," J'non said.ĬMS says agencies must know the cause of the gait abnormalities in order to provide services which meet health and safety needs for that patient, and are reasonable and necessary by industry standards for that particular injury, illness or medical condition.Īs for cases in which no reason for the symptom has been determined, CMS isn't buying it. "CMS says the reason for its stance on the use of symptom codes is that the underlying condition will dictate the treatment," said J'non Griffin, Home Health Solutions President and Owner. The final version of PDGM was released Oct. Other times elderly patients and their physicians decline to pursue further diagnostic testing because it can be expensive, time-consuming and - since these patients are homebound, problematic as far as getting to and from necessary appointments.īut CMS is standing by most of its earlier decision against R codes, saying in the finalized version of PDGM that agencies must refrain from using symptom codes as the primary diagnosis for the home health episode, with only a limited number of specific exceptions.
Sometimes physicians are still in the process of diagnosing the reason for the symptoms, agencies said.
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