Palliative Care 101
Insurance, self pay
Requires meeting Medicare's edibility requirements
What is Hospice
Provider isn't saying palliative care yet they have documented comfort care
No query needed
per CC ICD-9, Third Quarter 2010, pages 18-19
Provider has documented "End of Life Care", "He now wants to transition to comfort. His family is around him and supports his decision. Described potential scenarios and longevity of process for them as best as can be guessed. He died at 1210 with family at bedside." Is a query needed?
What is NO, you can capture Z51.5 without query
Can palliative care be PDx
What is yes, but....
per CC ICD 10, 1st Q 2017, pages 48-19 ("when palliative care is documented as the reason for the patient's admission")
Do you need to have a terminal diagnosis to receive palliative care?
What is NO
What is Palliative Care?
Documentation reflects palliative care being documented but the provider doesn't explicitly document it or the like
What is Query
Provider added Z51.5 Encounter for Palliative Care to the problem list which was brought into the discharge summary, without a date. Query needed?
What is YES, a query is needed
Should we capture palliative care if the patient does not have a terminal diagnosis
What is yes (a terminal dx is not required)
CC ICD 10, 4th Q, 2020, page 98
Name three common symptoms patients suffer that prompt palliative care treatment?
What are...
complex pain, depression, anxiety, fatigue, shortness of breath, constipation, nausea, loss of appetite, difficulty sleeping
Requires prognosis of 6 months or less by 2 physicians
What is Hospice?
Should I check if palliative care is captured or should be queried on all mortality accounts
What is YES
Provider documented terminal care and outlines care provided in POC. Query or capture?
What is capture
What is the code for palliative care
What is Z51.5
Name two non-physician providers that provide some form of palliative care. IE palliative care team members
Who are...
nurses, advanced care practitioners, registered dieticians, social workers, chaplains/spiritual advisors
Begins after treatment of the disease has stopped
What is Hospice?
"Family decided to withdraw care", "patient extubated to 2L NC" - should a query be placed?
What is YES, a query should be considered
Hospice nurse or social worker documentation reflects palliative. Provider/physician have not documented. Query or capture?
What is query
Name 2 frequently seen phrases that would trigger you to review for a palliative care query opportunity
What are...
Comfort measures, comfort care, terminal care, end of life care, withdrawal of care, hospice care
Who decides when a patient will stop curative treatment
Who is the patient?
Aimed at improving quality of life
What is both hospice and palliative care?
Provider has placed an order for "initiate comfort care". Is this enough to capture Z51.5
What is NO, a query would be needed
What is the code for DNR
What is Z66
Should I consider not using neutral on the speak up survey ;-)
What is yes