Palliative care: Difference between revisions
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{{ICD10 category|Healthcare contact}}{{ICD10 category|Misc}} | {{ICD10 category|Healthcare contact}}{{ICD10 category|Misc}} | ||
== Additional Info == | == Additional Info == | ||
*This | *This diagnosis code captures whether the clinical plan for the patient is to predominantly provide comfort towards the end of life, ''not'' to prolong life. | ||
*To figure out if a person should have this diagnosis of Palliative care, you must figure out the '''INTENT of care'''. If the intent is aimed at cure and prolonging life, then the person should '''not''' be assigned this diagnostic code. If the intent IS primarily control of symptoms (whether the person currently has symptoms or not), and ''not'' cure or even prolongation of life, then the person '''should''' be assigned this code. | *To figure out if a person should have this diagnosis of Palliative care, you must figure out the '''INTENT of care'''. If the intent is aimed at cure and prolonging life, then the person should '''not''' be assigned this diagnostic code. If the intent IS primarily control of symptoms (whether the person currently has symptoms or not), and ''not'' cure or even prolongation of life, then the person '''should''' be assigned this code. | ||
*We will operationalize this | *We will operationalize this diagnostic code as applying if ANY of the following 4 items are true: | ||
**1. ACP-C status | **1. ACP-C status | ||
**2. Had been on palliative care ''prior'' to this hospital admission (i.e. at home or in the care facility) -- and still is | **2. Had been on palliative care ''prior'' to this hospital admission (i.e. at home or in the care facility) -- and still is | ||
**3. Is receiving active palliation. What is meant by this is (again) related to the intent of care --- so receiving aggressive symptom control measures (e.g. a morphine drip) does not consitute active palliation UNLESS the intent of the overall care at this point is control of symptoms and not cure or even prolongation of life. | **3. Is receiving active palliation. What is meant by this is (again) related to the intent of care --- so receiving aggressive symptom control measures (e.g. a morphine drip) does not consitute active palliation UNLESS the intent of the overall care at this point is control of symptoms and not cure or even prolongation of life. | ||
**4. The Palliative Care Service (physician group) is seeing the patient in an '''ongoing''' fashion. This means that they have seen the patient at least twice during this admission, or that they wrote that they intended to follow but the patient died or left hospital before they could be seen a second time. Thus, if that consult team saw the patient in an initial consult but didn’t or didn’t plan to follow them longitudinally, then this item doesn’t apply. | **4. The Palliative Care Service (physician group) is seeing the patient in an '''ongoing''' fashion. This means that they have seen the patient at least twice during this admission, or that they wrote that they intended to follow but the patient died or left hospital before they could be seen a second time. Thus, if that consult team saw the patient in an initial consult but didn’t or didn’t plan to follow them longitudinally, then this item doesn’t apply. Do not use this code if palliative service is seeing the patient for non-palliative management of pain. | ||
*Note that this diagnosis code is not the same as ACP-C. A patient can qualify for this diagnosis code even if they're not ACP-C. Though if they are ACP-C, they do automatically qualify for this code. | *Note that this diagnosis code is not the same as ACP-C. A patient can qualify for this diagnosis code even if they're not ACP-C. Though if they are ACP-C, they do automatically qualify for this code. | ||
== Regarding Coding | == Regarding Coding [[Comorbid Diagnosis]] versus [[Admit Diagnosis]] versus [[Acquired Diagnosis]] == | ||
*This code can be used in any of | *This code can be used in any of [[Comorbid Diagnosis]], [[Admit Diagnosis]] or [[Acquired Diagnosis]]. | ||
*It is usually easy to figure out if the person met the criterion #2 (above), and if so this diagnosis should be in the | *It is usually easy to figure out if the person met the criterion #2 (above), and if so this diagnosis should be in the [[Comorbid Diagnosis]] [[Dx Type]]. | ||
*If the person doesn't meet one or more of the criteria until the day after admission, or thereafter -- then | *If the person doesn't meet one or more of the criteria until the day after admission, or thereafter -- then code it as an [[Acquired Diagnosis]] | ||
*It might be difficult, however, when they meet the criteria on the day of admission. In this case it may be either ''Related to Admission'' or ''After Admission''. | *It might be difficult, however, when they meet the criteria on the day of admission. In this case it may be either ''Related to Admission'' or ''After Admission''. | ||
**To decide, clarify the '''intent of care at admission'''. | **To decide, clarify the '''intent of care at admission'''. | ||
**If the initial intent ON ADMISSION was to try for cure and prolonging life, but this was changed to primarily symptom control later on the day of admission, then the appropriate | **If the initial intent ON ADMISSION was to try for cure and prolonging life, but this was changed to primarily symptom control later on the day of admission, then the appropriate [[Dx Type]] for this diagnosis is After Admission. | ||
**If the initial intent ON ADMISSION was '''not''' to try for cure or prolonging life, but primarily symptom control, then the appropriate | **If the initial intent ON ADMISSION was '''not''' to try for cure or prolonging life, but primarily symptom control, then the appropriate [[Dx Type]] is [[Admit Diagnosis]] -- even if it took some hours after admission to get the symptom control going. Code other relevant diagnoses and procedures with a priority lower than [[Palliative care]] | ||
== Alternate ICD10s to consider coding instead or in addition == | == Alternate ICD10s to consider coding instead or in addition == | ||
| Line 42: | Line 36: | ||
{{Data Integrity Check List}} | {{Data Integrity Check List}} | ||
== Legacy info == | |||
We used to code some similar concept under [[Palliative Service]]. That code had criteria based on involvement of the palliative service. The new ICD10 code can be used whether or not the service is involved. | |||
== Related Articles == | == Related Articles == | ||
Latest revision as of 11:06, 2022 October 20
| ICD10 Diagnosis | |
| Dx: | Palliative care |
| ICD10 code: | Z51.5 |
| Pre-ICD10 counterpart: | Palliative Service |
| 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 diagnosis code captures whether the clinical plan for the patient is to predominantly provide comfort towards the end of life, not to prolong life.
- To figure out if a person should have this diagnosis of Palliative care, you must figure out the INTENT of care. If the intent is aimed at cure and prolonging life, then the person should not be assigned this diagnostic code. If the intent IS primarily control of symptoms (whether the person currently has symptoms or not), and not cure or even prolongation of life, then the person should be assigned this code.
- We will operationalize this diagnostic code as applying if ANY of the following 4 items are true:
- 1. ACP-C status
- 2. Had been on palliative care prior to this hospital admission (i.e. at home or in the care facility) -- and still is
- 3. Is receiving active palliation. What is meant by this is (again) related to the intent of care --- so receiving aggressive symptom control measures (e.g. a morphine drip) does not consitute active palliation UNLESS the intent of the overall care at this point is control of symptoms and not cure or even prolongation of life.
- 4. The Palliative Care Service (physician group) is seeing the patient in an ongoing fashion. This means that they have seen the patient at least twice during this admission, or that they wrote that they intended to follow but the patient died or left hospital before they could be seen a second time. Thus, if that consult team saw the patient in an initial consult but didn’t or didn’t plan to follow them longitudinally, then this item doesn’t apply. Do not use this code if palliative service is seeing the patient for non-palliative management of pain.
- Note that this diagnosis code is not the same as ACP-C. A patient can qualify for this diagnosis code even if they're not ACP-C. Though if they are ACP-C, they do automatically qualify for this code.
Regarding Coding Comorbid Diagnosis versus Admit Diagnosis versus Acquired Diagnosis
- This code can be used in any of Comorbid Diagnosis, Admit Diagnosis or Acquired Diagnosis.
- It is usually easy to figure out if the person met the criterion #2 (above), and if so this diagnosis should be in the Comorbid Diagnosis Dx Type.
- If the person doesn't meet one or more of the criteria until the day after admission, or thereafter -- then code it as an Acquired Diagnosis
- It might be difficult, however, when they meet the criteria on the day of admission. In this case it may be either Related to Admission or After Admission.
- To decide, clarify the intent of care at admission.
- If the initial intent ON ADMISSION was to try for cure and prolonging life, but this was changed to primarily symptom control later on the day of admission, then the appropriate Dx Type for this diagnosis is After Admission.
- If the initial intent ON ADMISSION was not to try for cure or prolonging life, but primarily symptom control, then the appropriate Dx Type is Admit Diagnosis -- even if it took some hours after admission to get the symptom control going. Code other relevant diagnoses and procedures with a priority lower than Palliative care
Alternate ICD10s to consider coding instead or in addition
Candidate Combined ICD10 codes
Related CCI Codes
Data Integrity Checks (automatic list)
none found
Legacy info
We used to code some similar concept under Palliative Service. That code had criteria based on involvement of the palliative service. The new ICD10 code can be used whether or not the service is involved.
Related Articles
Show all ICD10 Subcategories