Can Cahaba provide guidance to us regarding whether we can use specific diagnosis codes as primary on our home health claims?
The diagnosis, whether primary or secondary, must originate with the physician, and be based on the patient’s condition. The primary diagnosis must be the chief reason for skilled home health care. Secondary diagnoses should be those diagnoses that are directly related to the home health plan of care, or those that may impact the home health plan of care. There are five allowances for secondary diagnoses in M1022 on the OASIS. If there are more than five secondary diagnoses, these should be included on the plan of care. Any diagnoses and codes used as the primary (M1020) or secondary (M1022) must follow the ICD-9-CM coding guidelines. Payment does not impact the ICD-9-CM coding process, and Cahaba cannot provide any additional guidance beyond what is found in the ICD-9-CM coding guidelines. (Jan.
