Palliative care Z515

fentona@bronsonhg.orgfentona@bronsonhg.org
in Clinical & Coding

I am looking for assistance please in sharing how your facilities use this code (Z515).

This is what our facility is using as a guideline


 Any input appreciate

Amy Fenton RN CDI Bronson Healthcare Group- Kalamazoo MI

 

Comments

  • sdemello@hhsc.orgsdemello@hhsc.org

    Does anyone have guidance on coding Z51.5? Is screening and referring patient to palliative care program enough? Or does a palliative care provider or Nurse from palliative care program need to visit the patient?

    Thanks,


    Shelly

  • annnd2009@gmail.comannnd2009@gmail.com

    Hello,

    I have a couple palliative code questions:

    1. with any DNR should palliative care be coded? because they are not going to resuscitate? or does it need to be stated? and "stated" is: end of life, palliative care, comfort measure?
    2. Would "terminal wean" automatically qualify for palliative care?
    3. if hospice consult is made (not palliative) doesn't that imply they think they will die in the next 6 months and are going to be performing palliative measures? Or NO because hospice could refuse due to not seeming to meet that criteria and care plan may be re-evaluated?
    4. if a hospice consult is made but not completed before patient expires, you could apply palliative code because the order implies the above and was correct?
    5. Could you ever have DNR without palliative?
    6. what was the message on this thread? Palliative Care Z515 — ACDIS Forums
    7. question on this thread Using Z51.5 Encounter for Palliative Care as Principal Dx — ACDIS Forums. if a patient arrived to ED and had LOC went to CT, couldn't they NOT be an IP at this point. and due to the assessment of that diagnostic test, they are elected NOT to put in IP. I know it sounds a little wonky, the reason I ask, is I recall years ago having a discussion about timing on diagnosing strokes and when the clocked started. Because in that particular core measure the time frame was "hospital days" rather than 24 hour clock. We had a fall out due to not meeting DVT prophalaxis and the quality director said we considered the arrival at 1130PM hospital day 1. The patient went to the CT scanner at 130 am so I suggested that should be hosptial day one- "how can you be held to a care standard of a diagnosis, when the diagnostic test to confirm the diagnosis hadn't been done at 1130pm?" Qnet agreed. so It made me wonder if we would put a patient into IP care when we expect they will expire. We may... it's just my question.

    Thank you!

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