Palliative Service

Legacy Content

This page is about the pre-ICD10 diagnosis coding schema. See the ICD10 Diagnosis List, or the following for similar diagnoses in ICD10:Palliative care

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Category/Organ System:	Category: Other Medical (old)
Type:	Category: Medical Problem (old)
Main Diagnosis:	Palliative Service
Sub Diagnosis:
Diagnosis Code:	90400
Comorbid Diagnosis:
Charlson Comorbid coding (pre ICD10):
Program:	Critical Care and/or Medicine
Status:	Currently Collected

A patient will have a "diagnosis" of palliative care 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.

See Comfort Care for collection instructions on that care goal.

Coding Instruction for Palliative Care Service

Palliative Service code should only be used as follows:

• 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

• COMPLICATION slots:
  • only if there is an actual consultation for Palliative Services after ward admission even if the patient was not accepted to that service

Possible change in collection

there was a question about palliation at beginning vs end of stay. It was discussed at task but never cleaned up. Could you have a look a this page? If this is all no longer an option, please delete the section. If it was resolved, then what did we decide? Or was that why we starte Comfort Care? Ttenbergen 00:01, 2018 November 27 (CST)

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Julie needs data on this at admission and at any time during admission. email cut-paste below.

can remove once ICD10 comes into play }}

• This has been around for a long time. emailed Julie to confirm if still relevant. Ttenbergen 21:02, 2018 March 22 (CDT)

From: Laura Kolesar Sent: Monday, May 29, 2017 2:29 PM To: Julie Mojica; Allan Garland; Constance Marks (HSC); Dan Roberts; Jo Anne Chartier; Jodi Walker-Tweed; Joyce Peterson; Tina Tenbergen; Trish Ostryzniuk Subject: RE: minutes attached from last week

We could make the comfort care temp item have 2 possible options: “ On admission” and “On discharge” just make a drop down option for the one that applies if any. Just a suggestion. Laura From: Julie Mojica Sent: Monday, May 29, 2017 2:05 PM To: Allan Garland; Constance Marks (HSC); Dan Roberts; Jo Anne Chartier; Jodi Walker-Tweed; Joyce Peterson; Laura Kolesar; Tina Tenbergen; Trish Ostryzniuk Subject: RE: minutes attached from last week

I still have an issue about Palliative. Sorry, I wasn’t listening attentively when we are discussing this. The data of interest and/or being requested are whether the patient is on palliation or on palliative care at admission and/or whether decision on palliation occur during the stay or at discharge.

We collect COMFORT CARE in tmp to address the issue that the patient is on palliation/ palliative care/ ACP-comfort or end of life care prior or at admission. – this is OK (no question)

Before Nov 2013, we have a DX code referring to PALLIATIVE CARE (904) with the same definition as COMFORT CARE and this can be either in ADMIT OR ACQUIRED dx. This code can addressed palliation question both at admission and during admission, correct?

Starting Nov2013, the dx code 904 had a new labelled ‘PALLIATIVE SERVICE” which I thought has the same meaning but seems NOT based on the discussion and WIKI. If this code is not tantamount to being in COMFORT CARE, then I am using the code 904 in acquired dx incorrectly. No one is asking data for patients under PALLIATIVE Service. The request is always whether the patient is actually on palliation prior to or at admission or became palliative at discharged .

Looking back, we should have used another code ( instead of 904) for Palliative service to differentiate the two so I won’t mix them up when analyzing long term period of data (say past 5 or 10 years).

Is there a way to have a similar COMFORT CARE (ACP C/palliation/end of life) at discharge?

Thanks,

Julie

Related data

The diagnosis code Palliative Service is unrelated to a patient having ACP C or Comfort Care orders, but you might be able to code Comfort Care in that circumstance.

See also

Category:End-of-life related data

Legacy info

Before Nov 11, 2013 "90400 - "Palliative Care" used to be applied as a code if a patient was either: comfort care, ACP C, palliation, end of life care or consulted to palliative care service.