AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2019 Issue 3; Ask the Editor

Home Health Care and Chronic Conditions

In the home health setting, should additional diagnoses be reported? For example, would an existing “stable” diagnosis, such as controlled diabetes or gastroesophageal reflux disease (GERD) be reported, when no direct care or intervention is provided? The ICD-10-CM Official Guidelines for Coding and Reporting state, “For reporting purposes the definition for ‘other diagnoses’ is interpreted as additional conditions that affect patient care in terms of requiring: clinical evaluation; or therapeutic treatment; or diagnostic procedures; or extended length of hospital stay; or increased nursing care and/or monitoring.”  However, the Uniform Hospital Discharge Data Set (UHDDS), which applies to home health agencies, defines “other diagnoses” as conditions that coexist at the time of admission, or that develop subsequently, or that affect patient care for the current hospital episode. Diagnoses that have no impact on patient care during the hospital stay are not reported, even when they are present. Diagnoses that relate to an earlier episode, and that have no bearing on the current hospital stay, are not reported.” ...

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