Medical noncompliance: Difference between revisions
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== Additional Info == | == Additional Info == | ||
*This code refers to a | *This code refers to a consistent PATTERN OVER TIME whereby a patient has not -- prior to admission -- followed doctors' orders for ''medical management'' in a way that may harm them. | ||
**Thus, it can be used as a comorbid diagnosis or an admit diagnosis, but should NOT be used as an acquired diagnosis. | |||
*This can occur either by willful choice, or the person now understanding the instructions, or even not being able to afford medications, etc. | *This can occur either by willful choice, or the person now understanding the instructions, or even not being able to afford medications, etc. | ||
*While this USUALLY means not taking their meds, it can also refer to not doing other things recommended in a way that may harm them (e.g. an MI patient who isn't going to cardiac rehab). | *While this USUALLY means not taking their meds, it can also refer to not doing other things recommended in a way that may harm them (e.g. an MI patient who isn't going to cardiac rehab). | ||
*In chronic | *In chronic hemodialysis population-those not showing up for or missing multiple treatments. | ||
*Those with chronic serious infections not showing up for their IV antibiotics in community | *Those with chronic serious infections not showing up for their IV antibiotics in community | ||
*Do not however, use this code simply to identify a patient who is medically incompetent to make their own decisions. | *Do not however, use this code simply to identify a patient who is medically incompetent to make their own decisions. | ||
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**e.g. where you should code it: Admitted for hypertensive emergency and was not taking prescribed anti-hypertensive medications | **e.g. where you should code it: Admitted for hypertensive emergency and was not taking prescribed anti-hypertensive medications | ||
**e.g. where you should '''NOT''' code it: Admitted for pneumonia, with hypertension as a '''[[Comorbid Diagnosis]]''' was not taking prescribed anti-hypertensive medications | **e.g. where you should '''NOT''' code it: Admitted for pneumonia, with hypertension as a '''[[Comorbid Diagnosis]]''' was not taking prescribed anti-hypertensive medications | ||
*Based on the above, this code should only be used as an [[Admit Diagnosis]], i.e. noncompliance with some aspect of their care is related to a medical reason for admission. So don't code it as a [[Comorbid Diagnosis]]. | |||
* | |||
== Alternate ICD10s to consider coding instead or in addition == | == Alternate ICD10s to consider coding instead or in addition == | ||
Latest revision as of 15:43, 17 February 2022
| ICD10 Diagnosis | |
| Dx: | Medical noncompliance |
| ICD10 code: | Z91.1 |
| Pre-ICD10 counterpart: | none assigned |
| Charlson/ALERT Scale: | none |
| APACHE Como Component: | none |
| APACHE Acute Component: | none |
| Start Date: | |
| Stop Date: | |
| External ICD10 Documentation | |
This diagnosis is a part of ICD10 collection.
Additional Info
- This code refers to a consistent PATTERN OVER TIME whereby a patient has not -- prior to admission -- followed doctors' orders for medical management in a way that may harm them.
- Thus, it can be used as a comorbid diagnosis or an admit diagnosis, but should NOT be used as an acquired diagnosis.
- This can occur either by willful choice, or the person now understanding the instructions, or even not being able to afford medications, etc.
- While this USUALLY means not taking their meds, it can also refer to not doing other things recommended in a way that may harm them (e.g. an MI patient who isn't going to cardiac rehab).
- In chronic hemodialysis population-those not showing up for or missing multiple treatments.
- Those with chronic serious infections not showing up for their IV antibiotics in community
- Do not however, use this code simply to identify a patient who is medically incompetent to make their own decisions.
- We are not seeking to specifically code or track people who are unable to make their own medical decisions.
- However, if there is a medical/neurologic/psychiatric reason for the patient to be deemed unable to make their own decisions, then code THAT entity.
- And if in such a setting the patient is medically noncompliant (as above), code that too.
- To operationalize this, only code it if the medical management with which they were noncompliant is directly or strongly related to an Admit Diagnosis
- e.g. where you should code it: Admitted for hypertensive emergency and was not taking prescribed anti-hypertensive medications
- e.g. where you should NOT code it: Admitted for pneumonia, with hypertension as a Comorbid Diagnosis was not taking prescribed anti-hypertensive medications
- Based on the above, this code should only be used as an Admit Diagnosis, i.e. noncompliance with some aspect of their care is related to a medical reason for admission. So don't code it as a Comorbid Diagnosis.
Alternate ICD10s to consider coding instead or in addition
Candidate Combined ICD10 codes
Related CCI Codes
Data Integrity Checks (automatic list)
none found
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