Home Health Care Coding


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We have received many questions regarding sequencing/coding from our clinical department since 1/1/08 pps changes have gone into play - I am wondering if you can help with the following case senerio:

In a "home health care" situation, a patient is admited to home care s/p hospitalization for pneumonia. He is on steriods and diabetes now uncontrolled. The pateint has PMH: MI, CAD, HTN, ESRO and CA. Also has GERD being treated with Prevacid. The physician has verified all diagnoses in writing.

Skilled Nursing is involved for BS/diabetes monitoring and cardiopulmonary assessment. GERD presently controlled with medication. Would GERD be chosen as one of the top six diagnoses even if the skilled nursing is not currently addressing (i.e. No GI problems included in nursing care plan) based solely on the fact that the patients has this confirmed diagnosis which may impact their care at any time.