Medical noncompliance: Difference between revisions

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{{ICD10 transition status

| OldDxArticle =| CurrentStatus = ~~freshly automatically generated article~~

| OldDxArticle =

| InitialEditorAssigned = ~~Pagasa Torres~~

| CurrentStatus = reconciled

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| InitialEditorAssigned = not assigned

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{{ICD10 dx

| MinimumCombinedCodes =

| ICD10 Code=Z91.1

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~~{{ICD10 category|Misc}}~~

== 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 ==

== ~~Alternate ICD10s to consider coding instead~~ ==

== Candidate [[Combined ICD10 codes]] ==

~~(turn these into links to the actual diagnosis articles if possible. For some that might make no sense.)~~

== Related CCI Codes ==

~~== Candidate [[Combined ICD10 codes]] ==~~

~~(put links to likely candidates coded with this one, eg. a cause for a trauma.)~~

== Related Articles ==

@@ Line 1: / Line 1: @@
 {{ICD10 transition status
-| OldDxArticle =| CurrentStatus = freshly automatically generated article
+| OldDxArticle =
-| InitialEditorAssigned = Pagasa Torres
+| CurrentStatus = reconciled
-| MinimumCombinedCodes =
+| InitialEditorAssigned = not assigned
 }}
 {{ICD10 dx
+| MinimumCombinedCodes =
 | ICD10 Code=Z91.1
 | BugRequired=
 }}
+{{ICD10 category|Misc}}
-{{ICD10 category|Misc}}
 == 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 ==
-== Alternate ICD10s to consider coding instead ==
+== Candidate [[Combined ICD10 codes]] ==
-(turn these into links to the actual diagnosis articles if possible. For some that might make no sense.)
+== Related CCI Codes ==
-== Candidate [[Combined ICD10 codes]] ==
+{{Data Integrity Check List}}
-(put links to likely candidates coded with this one, eg. a cause for a trauma.)
 == Related Articles ==
 {{Related Articles}}
+{{ICD10 footer}}
+{{EndPlaceHolder}}