Wondering if GomerBlog has any openings …
In its continuing effort to improve the accuracy of medical coding, the Centers for Medicare and Medicaid Services has announced a new ICD-10 code related to emergency department medical care. CMS spokesperson Marcella Skinner explains:
We have noticed an increasing trend of payments for emergency department patients sent from the nursing home in the middle of the night for evaluation of lethargy and being difficult to arouse. Initially, this appeared to be an anomaly, but when we analyzed the data over the past 10 years, we saw that this phenomenon has been occurring even before implementation of ICD-10, but under a different billing code – V60.5 (patient caregiver wants an afternoon off). Of course, this new code will be paid at a lower level since all patients in REM sleep are difficult to arouse, but at least it helps us track the sleep/wake cycles of our nation’s nursing home residents.
The new CMS ICD-10 code will be ZZZ317x – “Difficult To Arouse Due To REM Sleep – Nothing Really Wrong.” This code will supplement current ICD-10 codes of FULMA06c – Difficult To Arouse Due To Annoyance with Nursing Staff and OOPS08a – Difficult to Arouse Due to Previously Unnoticed Rigor Mortis.
Dr. Laurence Carmichael, Director of the VA Medical Center in Plucksburg, VA applauded the new change. “For years we’ve been making up symptoms so we get paid when wide awake smiling nursing home patients get transferred to the emergency department in the middle of the night. Now the government has finally recognized our plight and has created this new easy-to-remember code so that we can be compensated for our services. What a great step forward!”
Mary O’Leary, president of the American Nursing Home Association, had no comment.
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