Social Situation

kwilliams@halifaxrmc.orgkwilliams@halifaxrmc.org
in CDI Talk Archive
This is the first time I have run into a situation like I have. I am calling out to all that may have had anything like this in the past. Have a patient that was admitted as inpatient due to "discharge disposition problems". DC plan is for NH placement.

How in the name of Pete do you code this when it isn't a medical condition?

Any and all help would be greatly appreciated.

Comments

  • lmcnamara@cortlandregional.orglmcnamara@cortlandregional.org
    edited March 2016
    Unless the patient was a recent admission and did truly fail dc to home environment....this should be considered a social admission without medical necessity. At least maybe an observation stay, but with something, i.e. AMS, unsafe, inability to walk, weakness,UTI ...UR/CM should be made aware. The patient should not be considered an acute inpatient admission - there are medicare denial letters that should probably be issued to the patient. (usually UR or case management do this upon admission)

    Good luck, ...always on a Friday! ;)

    Lona

  • vanessa.falkoffvanessa.falkoff
    edited March 2016
    Hi,

    These kind of cases are usually changed due to intervention from case management to OBS or "out-pt in a bed" at UMC.

    Vanessa Falkoff RN
    Clinical Documentation Improvement Coordinator
    University Medical Center of Southern Nevada
    1800 W Charleston Blvd
    Las Vegas, NV
    vanessa.falkoff@umcsn.com
    office 702-383-7322

    Compassion * Accountability * Respect * Integrity



  • kwilliams@halifaxrmc.orgkwilliams@halifaxrmc.org
    edited March 2016
    Thank you for your responses. Oh my goodness.

    Kim Williams, RN
    Clinical Documentation Specialist
    Halifax Regional
    Revenue Management Department
    kwilliams@halifaxrmc.org
    (252) 535-8154
    (252) 535-8937 fax






  • Unknown
    edited March 2016
    Wow, not sure that meets criteria at all.. for inpt , however without reviewing could not say. I suspect if it were in our facility it would be turned to obvs status not inpt and we would suffer the loss.
    Sorry,
    Jamie Dugan RN CCDS
    Baptist Health
    Jacksonville Fl

  • lmcnamara@cortlandregional.orglmcnamara@cortlandregional.org
    edited March 2016
    And/or, my coders will often use Z75.1 (Z75 codes) Hope it helps

  • cynthia.hudson@christushealth.orgcynthia.hudson@christushealth.org
    edited March 2016
    You can't. It is not a justifiable admission per CMS guidelines.

    Syndi Hudson, RN, CCDS,CCM
    CHRISTUS Santa Rosa New Braunfels
    CDI Specialist
    cynthia.hudson@christushealth.org
    830-643-6116 (Office)
    830-643-5139 (Fax)
     
  • k2tweetyk2tweety
    Is there any treatment being offered? OT,PT..pulling straws would
    Z590 be feasible, or just should have been admit denial in first place?
    Just trouble shooting here:)


    Karen Macey RN CDI
    HIM Dept.
    (518) 314-3303
    KMacey@cvph.org
    The University of Vermont Health Network
    Champlain Valley Physicians Hospital
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