DNR status

fentona@bronsonhg.orgfentona@bronsonhg.org
in Clinical & Coding
I am wondering others thoughts on the following scenario:
Patient comes in and is a DNR status (Z66).  During the course of their stay, the patient may have had surgery and the code status was changed to full code, or someone had a discussion with the patient/family and they changed their mind to be a full code. 
Would you still capture the DNR (Z66) code as POA because that is what they came in with?
Any thoughts and input is greatly appreciated!!
Thanks,
Amy Fenton RN CDI
Bronson Healthcare Group
269 720 6650


Comments

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    No, I would not apply the status code DNR as the status was not applicable for the specific encounter given the patient changed status to full code.
  • fentona@bronsonhg.orgfentona@bronsonhg.org
    Paul, so on admission they are a DNR and say day 5 they are having surgery so have to be changed to a full code for surgery and recovery period, then say they go home day 8.  Would you code z66 poa or no and why?
    Thanks so much!!
    Amy
  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited July 2019
    Good question...have not researched to see if AHA has a formal opinion. Reversing my input as the ICD-10 Official Guidelines. FY 2019, pg 93 states:

    ”This code may be used when it is documented by the provider that a patient is on DNR status AT ANY TIMe during the stay”.

    Have you searched AHA?

    Paul
  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    I searched for specific guidance for this issue in AHA using software available to me, and I find no specific advice.  As such,  I’d cite and use the guidelines above. 

    Paul
  • fentona@bronsonhg.orgfentona@bronsonhg.org
    Thanks Paul!!!
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