Sepsis as Hospice Diagnosis

[lpoore]

Hi all! I wondered if sepsis can be used as a primary admitting diagnosis for hospice?

Thanks,

Linda

[MomRN0913]

I'm pretty sure it cannot be, but heart failure or multi organ system failure secondary to sepsis can be .

[NC29mom, ASN, LPN, RN]

What is sepsis from? Urosepsis r/t ES Dementia? Where was original source? The only way you could use "sepsis" would be to admit under debility, which the last I heard was not an appropriate Medicare admitting dx....

[TammyG]

There are several ICD-9 diagnoses related to sepsis. I don't know if there is an authorized list of ICD-9 codes for hospice. Does anyone know?

[NC29mom, ASN, LPN, RN]

Ive been in hospice for several years,and always thought we were limited to a "group" of hospice dx's (ES dementia, CVA, ES renal, COPD, ES cardiac, ALS, AIDS, CA). However, today I was reading on Medicare's website, and it said the terminal dx could be anything the dr listed as the probable cause of a life expectancy of

[MomRN0913]

End stage dementia isn't even an acceptable hospice diagnosis anymore or AFTT

[NC29mom, ASN, LPN, RN]

End stage dementia isn't even an acceptable hospice diagnosis anymore or AFTT

According to who?

It may be your employers decision not to use....but last I heard, not Medicares. They might not recommend using AFTT or Debility, but from what Ive read on medicares website...the terminal dx is whatever the dr reports as being the reason for life expectancy of 6m or <.>

[TammyG]

CMS announced that it is going to modify the hospice regulations to prohibit AFTT and general debility as hospice diagnoses in the next few months. It has been a large topic of discussion lately. We either changed our diagnoses on our AFTT patients or discharged them.

[AlliCat23]

To: NC29mom,

I am trying to PM you, but get an error message that your PM inbox has reached a limit and that you won't be able to receive any PMs until you delete some. I REALLY need your opinion about something that I don't want to post on the boards. Thanks!

[MunoRN, RN]

Is this new? I've never heard of sepsis (septicemia) not being an approved diagnosis for hospice, and at least a few years ago it was the most common DRG for transfers from hospitals to hospice:

http://oig.hhs.gov/oas/reports/region1/11200507.pdf

[NC29mom, ASN, LPN, RN]

Is this new? I've never heard of sepsis (septicemia) not being an approved diagnosis for hospice, and at least a few years ago it was the most common DRG for transfers from hospitals to hospice:

http://oig.hhs.gov/oas/reports/region1/11200507.pdf

I think you are misunderstanding the question. ....im pretty positive the original poster was referring to HOSPICE ADMITTING TERMINAL DIAGNOSIS. This is totally different than a DRG for which a hospital discharges to a sub-acute or hospice level of care. We dont use DRGs in hospice. ....

Sepsis is more of a symptom r/t to a diagnosis. ...like where did infection originate, or what was underlying cause? Whatever the answer... would likely be the hospice terminal diagnosis.

[jsoed9582]

Sepsis should be an allowable diagnosis for hospice. According to Medicare, they have guidelines for the more commonly used diagnosis, but no guidelines for specific illnesses. The diagnosis would be what the physician is stating gives the patient six months or less to live.

In Illinois, you are allowed to still use Dementia as an admitting diagnosis; however, in the near future, Medicare will be making the criteria for a dementia diagnosis much more strict. Medicare does not dictate what can and cannot be used, just what criteria must be met for the hospice benefit to be elected.