Wiki Hospice coders?

[jlynnhowe]

I need some assistance educating the non-coding side of my agency. Problem 1 is we're having too many patients whose primary is given as G31.1, problem 2 is that they're questioning why I'm sequencing I11.0 as the primary when the patient has both hypertension and heart failure and heart failure is the terminal diagnosis.
Problem 3, which no one has addressed with me but which I find recurring, is they keep listing CVA as the terminal diagnosis and trying to use I63.9 which isn't appropriate for a completed CVA. Am I off base here? Does anyone have resources or advice to share?

 

[Lera]

Re I11.0 and I50: Hospices may not report diagnosis codes that cannot be used as the principal diagnosis according to ICD-9-CM or ICD-10-CM Coding Guidelines or require further compliance with various ICD-9-CM or ICD-10-CM coding conventions, such as those that have principal diagnosis code sequencing guidelines.
https://www.cms.gov/files/document/r12083cp.pdf under Non-reportable Principal Diagnosis Codes to be returned to the provider for correction.
Above reference is valid for CVA issue as well. ICD 10 guidelines are pretty detailed on when to code CVA, personal history of CVA or residual deficits of CVA.