V57.1 as primary on OASIS .. = $$$$ what do you think?

[Monica RN,BSN]

I recently have learned that coding V57.1 as the primary on OASIS yields about 2,000 + more dollars per client in the HIPPS codes.

Interested in finding out how other agencies are coding for Physical therapy.

V57.1 is for physical therapy NEC

I then have been told to list the secondary as either 780.99 weakness

or an orthopedic dx such as CVA or other such diagnosis that is supported by Physical therapy.

Do you use a primary nursing diagnosis as a secondary if using a V57.1 as the primary on the OASIS?

What do you home care people think about this??

[renerian, BSN, RN]

I use that if it is a PT only case or the prime reason for care. I also back it up with relevant diagnosis based on Dr notes, order and such. I also code E codes for falls.

renerian

[NRSKarenRN, BSN, RN]

Doing that should also reflect M0825 as yes, 10 or more visits.

[Monica RN,BSN]

I use that if it is a PT only case or the prime reason for care. I also back it up with relevant diagnosis based on Dr notes, order and such. I also code E codes for falls.

renerian

Thanks Ren.. I hoped you would help me here... know you have been in home care for ever.. I have been in it over 10 years off and on, and now I am back at it again full time. I love home health... just wondered about this crazy coding. I never have used an E code.. Not really sure how that one works.

Thanks

MO

[renerian, BSN, RN]

Monica I am considering leaving management in home health and going back in the field. I love home health but am rather tired of the office politics.

renerian

[erroridiot]

Monica I am considering leaving management in home health and going back in the field. I love home health but am rather tired of the office politics.

renerian

Under great pressure to upcode and ignore the best interest of the patients, I am not considering leaving management in home care - I am planning to do so as soon as possible.

I will not go to jail for any home health agency.

C.M.S. can come in and do a "lookback" anytime.

Office politics are a joke.

I hope things get better for you.

[renerian, BSN, RN]

I am hearing that from other nurses in home health. I understand the implications and am myself looking for new employment. (intent hidden in that statement/big smile.

Have a great day!

renerian

[NRSKarenRN, BSN, RN]

ETHICAL STANDARDS

Look for a homecare organization that has that....especically those that are part of Visiting Nurses of America.

Changeing codes IS acceptable if done properly as part of an internal audit to ensure consistency within an organization and meet revised coding standards as long as the DOCUMENTATION supports the change.

In merging the culture of four homecare agencies, I've found many persons are not really aware how to accurately determine a primary diagnsois beyound what the intake dept gives them as diagnosis even after years of experience.

All hh coders should attend a workshop on this or at minimum review the links posted here on topic.

[Shell7280]

at the agency i was working at our norm was to code v57.1 (pt) as primary if it was the primary reason we were in the home, not necessarily the only service provided though. then as the first of the secondaries i would put the main dx causing the need for pt. then in the payment codes a and b - put the two main dx causing the need.

michelle

[alintanurse]

at the agency i was working at our norm was to code v57.1 (pt) as primary if it was the primary reason we were in the home, not necessarily the only service provided though. then as the first of the secondaries i would put the main dx causing the need for pt. then in the payment codes a and b - put the two main dx causing the need.

michelle where i worked -that's how v codes were supported also.