Medical noncompliance: Difference between revisions
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**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]]. | *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]]. | ||
{{Discuss| Can this code be used as a comorb dx? if used as an admit code can this be combined with another code or is listed lower down on admit priority list by itself? Can this code be an acquired dx for ie. patients who choose to leave AMA or patients that refuse recommended care/tx such as medications, vital signs, etc.? Thanks! }} | |||
== Alternate ICD10s to consider coding instead or in addition == | == Alternate ICD10s to consider coding instead or in addition == | ||
Revision as of 13:37, 2021 October 27
| 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 pattern whereby a patient has not -- prior to admission -- followed doctors' orders for medical management in a way that may harm them.
- 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.
|
Can this code be used as a comorb dx? if used as an admit code can this be combined with another code or is listed lower down on admit priority list by itself? Can this code be an acquired dx for ie. patients who choose to leave AMA or patients that refuse recommended care/tx such as medications, vital signs, etc.? Thanks! |
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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