Top 20 Principal Hospice Diagnoses for 2017

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  • May 9, 2018
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Top 20 Principal Hospice Diagnoses for 2017

Since the implementation of the hospice benefit in 1983, the number of Medicare beneficiaries receiving hospice services has grown from 513,000 in 2000 to nearly 1.5 million in 2017. Over the years, there have been changes in the diagnosis patterns among Medicare hospice enrollees — largely due to changes in coverage.
In 2002, lung cancer was the top principal diagnosis. But for the past five years, neurologically based diagnoses have topped the list. In 2013, “debility” and “adult failure to thrive” were the first and sixth most common hospice claims-reported diagnoses, respectively, accounting for approximately 14 percent of all diagnoses.
Effective October 1, 2014, these diagnoses are no longer permitted as principal diagnosis codes on hospice claims. As a result, the most common hospice claims-reported diagnoses have changed from primarily cancer diagnoses to neurological and organ-based failure diagnoses.
Here are the top 20 most frequently hospice claims-reported diagnoses for 2017.

Rank ICD-10 principal diagnosis Percentage
1 G30.9 Alzheimer’s disease, unspecified 10
2 J44.9 Chronic obstructive pulmonary disease 5
3 I50.9 Heart failure, unspecified 4
4 G31.1 Senile degeneration of brain, not elsewhere classified 4
5 C34.90 Malignant neoplasm of unspecified part of unspecified bronchus or lung 3
6 G20 Parkinson’s disease 3
7 G30.1 Alzheimer’s disease with late onset 2
8 I25.10 Atherosclerotic heart disease of native coronary art without angina pectoris 2
9 J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation 2
10 I67.2 Cerebral atherosclerosis 2
11 C61 Malignant neoplasm of prostate 2
12 I63.9 Cerebral infarction, unspecified 1
13 N18.6 End stage renal disease 1
14 C18.9 Malignant neoplasm of colon, unspecified 1
15 C25.9 Malignant neoplasm of pancreas, unspecified 1
16 I1.9 Heart disease, unspecified 1
17 I11.0 Hypertensive heart disease with heart failure 1
18 I67.9 Cerebrovascular disease, unspecified 1
19 I13.0 Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease 1
20 A41.9 Sepsis, unspecified organism 1

Source: FY 2017 hospice claims data from the CCW, accessed and merged with ICD-10 codes on January 10, 2018.

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Renee Dustman, BS, AAPC MACRA Proficient, is managing editor - content & editorial at AAPC. She holds a Bachelor of Science degree in Media Communications - Journalism. Renee has more than 30 years' experience in journalistic reporting, print production, graphic design, and content management. Follow her on Twitter @dustman_aapc.

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