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  #1  
Old 09-03-2009, 07:19 AM
abill_423 abill_423 is offline
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Default How to code "deconditioning"

Can someone tell me how they would code "deconditioning"? Would you code this as 799.3 Debility, unspecified or 728.2 Muscular wasting and disuse atrophy, NEC?
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Old 09-03-2009, 07:32 AM
RebeccaWoodward* RebeccaWoodward* is offline
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I think it really depends on the physicians documentation and his use of this term...

Deconditioning=diminished ability or perceived ability to perform tasks involved in person’s usual activities of daily living.

728.2=Use this code for muscle wasting and atrophy due to disuse, where the condition is not classified elsewhere. For example, myofibrosis, in which muscle tissue is replaced by fibrous (scar) tissue, would fall under this category.

799.3=Any unspecified debility that impairs the patient's life in some way.

I could see either one...but I do think it depends on the physicians use and his/her documentation
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Old 09-03-2009, 09:52 AM
abill_423 abill_423 is offline
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Thanks. There's not much in the note except that the patient is unable to get out of bed. The note also says that she has a lot of weakness. She has fibromyalgia, degeneration of the cervical disc, and chronic lumbar pain.
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Old 09-03-2009, 09:59 AM
RebeccaWoodward* RebeccaWoodward* is offline
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Based on your information, I would go with 799.3 since the "weakness/unable to get out of bed" could be perceived as a "debility that impairs the patient's life in some way." I would be hesitant to use 728.2 since this speaks more about muscle wasting/atrophy.
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Old 09-03-2009, 12:04 PM
abill_423 abill_423 is offline
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Thanks again for your response. That's how I coded it but I was second guessing myself.
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Old 09-04-2009, 06:39 AM
LTibbetts LTibbetts is offline
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Unfortunately, our physicians use this diagnosis for almost every single Swingbed patient that comes through here. I usually go with 728.87 but sometimes I do use the 799.3, depending on what documentation the provider gives me. I have seemed to have had a lot of luck with the 728.87 as far as Medicare and payment, etc. I really wish the providers would use use a more definitive description of the primary diagnosis but I am afraid that it has become almost a habit for them to use this Dx.
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Old 09-04-2009, 07:01 AM
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mitchellde mitchellde is offline
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I asked a physician I worked with about this term "deconditioned" and he stated that this is a non-specific term and not a dx. He stated that it will mean different things to different physicians depending on their specialty and the general condition of the patient. In otherwords not a codable dx. He stated after he was questioned about it by a coder he did some investigation and decided that this term really should not be used and if it is, it is not codable. He said a physician should always be querier as to the specific signs, symptoms or condition of the patient.
I know this is not much help but I thought you would be interested in a physician view.
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Old 09-04-2009, 08:26 AM
LTibbetts LTibbetts is offline
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Deb, that is Very interesting news. Do you by any chance know where he did his research and found this out? I would love to have something in writing to show our physicians in order to correct this. You have no idea how many of our docs do this, and the time it takes to query all of them holds up our A/R quite a bit, you know? They use for almost every swingbed chart, and as a CAH we have quite a few of those. That is great that the docs you work with are so receptive to advice and/or any kind of coding knowledge. Any help would be great!
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Old 09-04-2009, 08:30 AM
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I will talk to him and see what I can get, he is a Hem/onc specialist.
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