Home Health ICD-9/ICD-10 Alert

READER QUESTIONS:

Check With Clinician For Return Patient Dx

Question: How do we know what to list first for a patient who is returning to home care? For example, we have a patient who was receiving aftercare for a pelvic fracture. She went out to the hospital for congestive heart failure (CHF). Now that she's back at home, I'm not sure how we should code for her.


Utah Subscriber


Answer: Always code the condition that is the chief reason for home care first.

When the agency resumes care with this patient, you need to consider whether the chief reason for home care has changed based on the new or exacerbated diagnosis or if the aftercare for the fracture is still the focus of care.

The assessing clinician should determine which diagnosis you will code as primary based on the assessment findings and plan of care.