Acute codes belong in home health


We usually think of acute diseases as being those treated outside of home health, but is that always the case? What if you have a patient who is still in an acute phase, and has been admitted with acute pancreatitis? Can it go in M1020?

In general, pancreatitis not resolved is probably acute. It is entirely correct to code acute conditions in home health when they still exist. Many codes, in fact, include a guideline stating to code as acute unless the physician documents chronic. The statement that home health cannot take care of acute patients is entirely incorrect.

This is a statement from the Medicare Benefit Policy Manual regarding skilled nursing:
The determination of whether a patient needs skilled nursing care should be based solely upon the patient’s unique condition and individual needs, without regard to whether the illness or injury is acute, chronic, terminal, or expected to extend over a long period of time. In addition, skilled care may, depending on the unique condition of the patient, continue to be necessary for patients whose condition is stable.

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