Home Health & Hospice

Homecare Aptitude Test: 2009 Coding Changes

Homecare Insider, January 5, 2009

On October 1, 2008, annual updates to the International Classification of Diseases, 9th Clinical Modification (ICD-9-CM), took effect. Some of these changes have an impact on diagnosis coding and payment for homecare providers. Test your knowledge with these true-or-false questions.

1. A V code for personal history generally supports reasonable and necessary service delivery.
2. The patient’s primary reason for homecare is treatment of a Stage IV pressure ulcer on his hip. Report pressure ulcer – hip (707.4) as the principal diagnosis with pressure ulcer Stage IV (707.24) as the first pertinent.
3. Secondary diabetes (249) is a new case-mix diagnosis for patients in the Prospective Payment System (PPS).
4. A new case-mix diagnosis code, coronary atherosclerosis due to lipid rich plaque (414.3) is a manifestation code.
5. The newly released “Attachment D: Selection and Assignment of OASIS Diagnoses” dramatically changes the approach to homecare coding.

Scroll down for the answers.






Here are the answers for the Homecare Aptitude Test.
1. False. A history code describes a past medical condition that no longer exists and is not receiving any treatment.
2. False. The stage of a pressure ulcer cannot serve as the principal or first pertinent diagnosis.
3. False. Secondary diagnosis is a new diagnosis but it is not case-mix for patients in the PPS.
4. True. Coronary atherosclerosis due to lipid-rich plaque is a manifestation of coronary atherosclerosis.
5. False. The updated attachment to Chapter 8 of the OASIS Implementation Manual provides guidance for diagnosis coding and reaffirms the important principles.

If you want to learn more about the updates and their impact on diagnosis coding and payment in the PPS, sign up for Beacon Health’s audio conference on January 15. Click here — for more information.