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| {{DX tag | Other Medical | | Palliative Care | PALLIATIVE CARE | 904-00 | | |'''Critical Care and/or Medicine''' | Currently Collected | |}}
| | See [[Palliative care]]. |
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| I am hoping that this article won't grow as big as a zit like it was before.
| | {{PreICD10 dx | NewDxArticle = Palliative care}} |
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| ==When to code as an Admit or Complication DX==
| | {{DX tag | Other Medical | Medical Problem | Palliative Service | | 90400 | | |'''Critical Care and/or Medicine''' | Currently Collected | |}} |
| Palliative Care DX should be coded as follows: | |
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| *ADMIT diagnosis: only coded in admit DX if the patient has been previously enrolled in and is currently being cared for by the Palliative Care Service.
| | A [[palliative patient]] will have a "diagnosis" of Palliative Service if the patient is either under the care of Palliative Service Team or that this Service has been consulted. We code '''Palliative Service''' as a diagnosis because we did not have a reasonable alternative way to code it when we started to collect it. |
| *COMPLICATION DX diagnosis: only code as a complication if there is an actual consultation for Palliative Care Services after ward admission.
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| {{Discussion}}
| | See [[Comfort Care]] for collection instructions on that care goal. |
| *** Trish I have a question for you I have a pt who has pneumonia CAP gets worse Docs says ACP C stop meds leave a bit of O2 on no blood work. I put complication Palliative care (med ward) pt dies in 3 days. Are you saying we should only use the word palliative if a consult to that service was done or if the pt had it prior to coming to the unit?Was DC treatment only at one time used in ICU and that was for when the ventilator was stopped and inotropes were d/c and the pt died very quickly with in hours. Is not palliative care =comfort care=ACP C care not the same?
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| ****Can’t use palliative care in complication DX slot because palliative care service was not consulted as per this new definition above. I don't know what ACP C is. See [[Comfort/End of life care]] for information when to collect this info. [[User:TOstryzniuk|Trish Ostryzniuk]] 19:12, 2013 October 24 (CDT)
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| ****This does present a good question though, what do we do with patients who are made "comfort care" and they do not have a palliative consult?? Do we not code anything for this? We will miss this information if we do not put anything in the complication section. Is this what you want?--[[User:LKolesar|LKolesar]] 10:56, 2013 October 28 (CDT)
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| ***** Yes, we will miss this information. Like many other things we don't code. If we need this information at some point we can start collecting it. Ttenbergen 10:59, 2013 October 28 (CDT)
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| *****I think we need to clarify with Dr.Garland to ensure that this information is not important to include in our complication codes. Another option would be to make a separate code "ACP C" and then the palliative code could be worded, "palliative consult" to make it clearer. The ACP coding system is the same throughout the WRHA and is a widely accepted system. It seems odd that we cannot use this in the database as least for the ACP C patients. It would greatly clarify our coding and the outcomes on many patients.
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| ******Appreciate the question and input. Hope we can shrink this article down shortly. The medicine program is only interested in tagging patients whom it is known at the start of a ward admission that the plan is comfort care only and thus to tag it in TMP. The medicine program is not interested on tagging those patient that become ACP C or comfort care '''AFTER''' ward admission. There comes a point were the database program has to decide where to limit collection details otherwise it is endless and you get collection creep going on. This is the same for Palliative care. Medicine program has chosen a definition so that any research or data modeling that is being done from our database, this element is clear on how it is being collected and thus can be explained. I have put this forward to Allan in an email since he was the person who went to get interpretation from Dan. [[User:TOstryzniuk|Trish Ostryzniuk]] 20:00, 2013 October 28 (CDT)
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| *******(CDT)http://www.wrha.mb.ca/professionals/acp/index.php here is the link for you Trish.
| | == Coding Instruction for Palliative Care Service== |
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| | Palliative Service code should only be used as follows: |
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| | *ADMIT slots: |
| | **only if the patient is either under the care of Palliative Service Team or that this Service has been consulted, ''even if the patient was not accepted to that service'' |
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| | *COMPLICATION slots: |
| [[Category:Diagnosis Coding]]
| | **only if there is an actual '''consultation''' for Palliative Services '''''after''''' ward admission ''even if the patient was not accepted to that service'' |
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| == DC Treatment vs. Palliative Care == | | == Related data == |
| see [[DC_Treatment#DC_Treatment_vs._Palliative_Care]] | | The diagnosis code Palliative Service is related to, '''but not the same as''' a patient having [[ACP-C]] or [[Comfort Care]] orders, but you might be able to code [[Comfort Care]] in that circumstance. |
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| | ==See also== |
| | [[:Category:End-of-life related data]] |
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| | == Legacy info == |
| | see [[palliative patient]] |
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| | [[Category:End-of-life related data]] |