Home Health ICD-9/ICD-10 Alert

Published on Fri Nov 26, 2004 PDF

Improve reimbursement - give each of your coders a copy.

There are no more excuses for not recognizing a case mix code. Here they are at your fingertips.
 
Add this tool to the Orthopedic Case Mix Reference Sheet from last month's issue of Home Health ICD-9 Alert and keep it near you when you code. Now you'll have a quick way to know when you are using a case mix code or when you have replaced one with a V code as primary, and need to put the case mix code in M0245.

Codes shown as 3 digits include all related 4 and 5 digit codes. Codes shown with 4 or 5 digits must be coded as shown to receive score in the clinical dimension.

Editor's Note: Qualifying neurological diagnosis codes add 20 points to the clinical severity domain of the Home Health Resource Group for a patient's episode of care. Diabetic diagnosis codes add 17 points. Codes listed as secondary in the chart above are ones the ICD-9-CM coding guidelines say should never be used as a primary diagnosis. The case mix system recognizes them as adding clinical points if they appear as the first secondary diagnosis (M0240) or on line b of M0245. 

Would this chart be useful to your coworkers or employees? Feel free to copy and distribute the charts on these two pages.

Source: PPS final rule, published in July 3, 2000 Federal Register and updates.