Wiki Guidelines for use of Z66 Do Not Resuscitate

proucken

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According to ICD 10 guidelines 2020, "This code may be used when it is documented by the provider that a patient is on do not resuscitate status at any time during the stay". Based on my research, use of this code is based on the physician's order written in the hospital, nursing home or home for those receiving home care. My FQHC had a patient mention to the provider at an office visit that she wanted "DNR" but did not fill out the necessary paperwork and further discussion/order was not written by the provider, only the reference that patient will fill out a POLT at the next visit. I removed the Z66 code from the claim.

Can anyone confirm the above information and suggest any further guidance on use of this code to help train providers in the office setting?
 
You are correct - the code would only be reported if there is a physician order documented and in place on the record during that stay. I would recommend not using the code in the office setting because DNR orders are specific to the facility and do not apply once the patient has been discharged. If the patient is admitted again, a new DNR order has to be put in place. There really is no such thing as a DNR status outside of a facility because the order is a physician treatment direction to the staff of that facility as to how to respond - it does not carry over into the community setting.
 
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