Wiki Noncompliance: When to code?

[kpeterson15]

Hello everyone! I am currently a coding student and came across a question I can not find online or in the forum anywhere else. My question is, what are the specific documentation is required in order to use the noncompliance codes?
If the doctor states the patient has stopped taking his coumadin due to reasons unknown to him(the patient), could you code noncompliance intentional? Or what if the doctor states patient missed his dialysis appointment, could you code noncompliance to renal dialysis, Z91.15?

Just want some clarification on when to use noncompliance codes!
Thanks!
-Student

 

[Pam Warren]

Your provider must use the words 'noncompliance' in terms of their care. A coder may not assume non-compliance simply because of missed appointments or discontinuing medication. Maybe they don't have the $$ for the medication or they didn't have a ride. Unless the provider specifically uses the term (and they rarely do, because this code will likely cause a denial), I'd steer away from using that code---ever.

 

[kpeterson15]

Your provider must use the words 'noncompliance' in terms of their care. A coder may not assume non-compliance simply because of missed appointments or discontinuing medication. Maybe they don't have the $$ for the medication or they didn't have a ride. Unless the provider specifically uses the term (and they rarely do, because this code will likely cause a denial), I'd steer away from using that code---ever.

Thank you for your reply! It was very helpful.