Hospice Providers, take note

To be quite honest, I have never seen a ‘no code’ list in hospice.  If anything, I would expect to see a ‘full code’ list as any code status besides DNR would be the exception.

And yet, there is a new list of codes that hospices may not use when determining the primary reason for hospice care.   A list of codes at the end of this document will be automatically returned to providers when used as a principle code for hospice for claims billed after October 1.

This information comes from CMS change request 8877 which also contains very important information about the Notice of Election.

Home Health Providers:

An updated Local Coverage Determination has been published by Palmetto GBA for Alzheimer’s Dementia.  Among the insightful gems included in this guidance is the following passage begging the question of, ‘does someone have too much time on their hands?’

Behavioral disturbances often complicate the medical management of beneficiaries with Alzheimer’s disease. At baseline many individuals with Alzheimer’s disease manifest activity limitations in such domains as communication and self-care. The occurrence of behavioral disturbances, if not addressed in a comprehensive and systematic manner, may further compromise the activity limitations present at baseline – resulting in sub-optimal clinical outcomes.

Wow.  I’m glad we cleared that up.  Seriously, look how often the word, ‘baseline’ is used.  If you really want to get paid, consider using the FAST scale to stage Alzheimer’s on admission and recert.  There are also numerous documentation requirements.  Please review and document accordingly.

If you recall, numerous claims once denied for Face-to-Face documentation are now being denied for lack of both long and short term goals.  The reference to short and long term goals is listed as the Physical Therapy LCD.  I am quite certain that the Alzheimer’s documentation LCD will be used in the same way.

Both of these regulations will take place on October 1.  Be ready.

 

The Hospice No Code List

290.0	Senile Dementia Uncomplicated
290.10	Presenile Dementia Uncomplicated
290.11	Presenile Dementia With Delirium
290.12	Presenile Dementia With Delusional Features
290.12	Presenile Dementia With Delusional Features
290.13	Presenile Dementia With Depressive Features
290.20	Senile Dementia With Delusional Features
290.20	Senile Dementia With Delusional Features
290.21	Senile Dementia With Depressive Features
290.3	Senile Dementia With Delirium
290.3	Senile Dementia With Delirium
290.40	Vascular Dementia Uncomplicated
290.41	Vascular Dementia With Delirium
290.42	Vascular Dementia With Delusions
290.43	Vascular Dementia With Depressed Mood
290.8	Other Specified Senile Psychotic Conditions
290.9	Unspecified Senile Psychotic Condition
293.0	Delirium Due To Conditions Classified Elsewhere
293.1	Subacute Delirium
293.81	Psychotic Disorder With Delusions In

293.82	Psychotic Disorder With Hallucinations In Conditions Classified Elsewhere
293.83	Mood Disorder In Conditions Classified Elsewhere
293.83	Mood Disorder In Conditions Classified Elsewhere
293.83	Mood Disorder In Conditions Classified Elsewhere
293.83	Mood Disorder In Conditions Classified Elsewhere
293.83	Mood Disorder In Conditions Classified Elsewhere
293.83	Mood Disorder In Conditions Classified Elsewhere
293.89	Other Specified Transient Organic Mental Disorders Due To Conditions Classified Elsewhere
294.20	Dementia, Unspecified, Without Behavioral Disturbance
294.21	Dementia, Unspecified, With Behavioral Disturbance
294.8	Other Persistent Mental Disorders Due To Conditions Classified Elsewhere
294.8	Other Persistent Mental Disorders Due To Conditions Classified Elsewhere
310.0	Frontal Lobe Syndrome

310.1	Personality Change Due To Conditions Classified Elsewhere
310.2	Postconcussion Syndrome
310.89	Other Specified Nonpsychotic Mental Disorders Following Organic Brain Damage
310.9	Unspecified Nonpsychotic Mental Disorder Following Organic Brain Damage