B95.0 Streptococcus, group A, as the cause of diseases classified elsewhere. These very short stays in hospice are considered too short a period for patients to fully benefit from the unique person-centered, interdisciplinary care provided by hospice. 5. Value-Based Insurance Design (VBID) Model: Hospice Benefit Component. ICD-10-CM official coding and reporting guidelines April 1, 2020 through September 30, 2020. Hospice is a medical service based on a holistic approach to providing quality end-of-life care to patients. 2000 Winter;3(4):441-7. doi: 10.1089/jpm.2000.3.4.441. Treasure Island (FL): StatPearls Publishing; 2022 Jan. Would you like email updates of new search results? There should be a frequent re-evaluation of the patients status as appropriate for continued hospice care through the lens of physical, mental, social, and spiritual needs. Since the implementation of the hospice benefit in 1983, the number of Medicare beneficiaries receiving hospice services has grown from 513,000 in 2000 to nearly 1.5 million in 2017. is it okay to take melatonin after covid vaccine. Cherlin EJ, Brewster AL, Curry LA, Canavan ME, Hurzeler R, Bradley EH. 1. 2017 Jun;53(6):1050-1056. This is the text area to add more information about this section. In 1998, the average LOS for hospice patients was 48 days, but by 2006 it had risen to 73 days (a 52% increase). Brief Issue Description. Since 2006, the average LOS has begun to decline slightly, dropping to 71 days in 2009, which is a 48% increase from 1998. Heres how you know. Federal government websites often end in .gov or .mil. The following clinical signs often support hospice eligibility in combination with another primary diagnosis. TIP: What could the patient do 12 months ago that he/she can no longer do? 1. See a summary of key provisions effective October 1, 2022: Routine annual rate setting changes resulting in a 3.8% increase in payments for FY 2023. See asummary of key provisions effective October 1, 2022: Recruitment Announcement Technical Expert Panel (TEP) for Hospice Special Focus Program (SFP) Development. The coinsurance amount may not be more than the inpatient hospital deductible for the year that the hospice coinsurance period began. Usually, hospice care is offered in the home, or sometimes in a nursing home. We invite you to contact our team of Hospice Physicians with any questions about a patient's eligibility or about hospice care, at (888 . Coding has always been important in home care, but is increasingly being scrutinized. hbbd```b``[@$f) fe7`LHFM V,. B95.0. 1. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, ICD-10-CM and ICD-10 PCS and GEMs Archive, ICD-10 Coordination and Maintenance Committee Meetings, Process for Requesting New/Revised ICD-10-PCS Procedure Codes, ICD-10 Coordination and Maintenance Committee Meeting Materials, ICD-9-CM Diagnosis and Procedure Codes: Abbreviated and Full Code Titles, Updates and Revisions to ICD-9-CM Procedure Codes (Addendum), 2020 Code Descriptions in Tabular Order (ZIP), UPDATED Coding Guidelines for COVID-19 Effective April 1, 2020, ICD-10-CM Chapter 22 New Vaping Code Index and Tabular. ICD-10 Diagnosis G30.9 Alzheimer's Disease G31.01 Pick's Disease G31.1 Senile Degeneration of Brain G31.85 Corticobasal Degeneration . -. Typically, there is an interprofessional team focus led by a physician medical director. Secure .gov websites use HTTPSA Progressive inanition is documented by several measures such as 10% body weight loss, decreased albumin, and dysphagia leading to aspiration, among others. LISTS OF ACCEPTABLE DOCUMENTS All documents must be UNEXPIRED Employees may present one selection from List A or a combination of one selection from List B and one selection from List C. LIST A 2. Please click on the Accept and Close button to affirm your consent and continue to use our website. 142 0 obj <>/Filter/FlateDecode/ID[<44A1530AAAB28041BB962D82D60B3EBC><7104D47576CF0547B32B8685CFCAA49E>]/Index[107 55]/Info 106 0 R/Length 150/Prev 174524/Root 108 0 R/Size 162/Type/XRef/W[1 3 1]>>stream As with each new set of guidelines, revised standards, or updated ICD codes, there are further changes to the interpretation and guidance of hospice diagnoses and regulations. https:// Download the new report, NHPCO Facts and Figures (PDF). Communications, Director If you have questions, reach out to Compassus at 833.380.9583. In the new PDGM (Patient Driven Groupings Model) payment model effective 2020, the Primary Dx will be very important in order to determine what payment group your claim will fall under. I. or This represents an increase of 18.3 percent since 2014. Category. There is no FY 2020 GEMs file. Teoli D, Bhardwaj A. Hospice Appropriate Diagnoses. In the nearly forty years that the Medicare hospice benefit has been in place, weve seen a significant shift in the primary diagnoses, how communities access care, length of service, and how hospice is made available, said NHPCO President and CEO Edo Banach. The Nomination Form is available at this link: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Spotlight, The nomination form and general questions about the Hospice SFP TEP shall be sent to. Treasure Island (FL): StatPearls Publishing; 2022 Jan. In other words, hospice services are for patients with a prognosis of 6 months or less until their death, yet patients are not utilizing hospice services until only 2.5 months until death. For several decades, hospices primarily served people with cancer diagnoses. Determining Eligibility. 1. All diagnoses Stroke and Coma. 50.7 percent of Medicare decedents were enrolled in hospice at the time of death. 20. Executive Summary A. The coinsurance for each prescription may not be more than $5.00. CMS issued a Fiscal Year (FY) 2023 Hospice Payment Rate Update final rule to update Medicare hospice payments, wage index, quality reporting programs, and policies. - The two diagnoses may interact with one another, resulting in higher resource use. ), which permits others to distribute the work, provided that the article is not altered or used commercially. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Hospice Information for Medicare Part D (ZIP), Instruction and Form for Hospice and Medicare Part D (PDF), Model Hospice Election Statement Addendum - July 2021 (PDF), Model Example of Hospice Election Statement (PDF), Ejemplo modelo de la Declaracin de eleccin de hospicio (PDF), Modelo de Referencia de "Aviso al Paciente sobre Artculos, Servicios y Medicamentos de Hospicio No Cubiertos" (PDF), Hospice Request for Certification in the Medicare Program - Form CMS-417, Advance Beneficiary Notice of Non-Coverage - Form CMS-R-131 (ZIP), Hospice Care Regulation: Title 42, Chapter IV, Part 418, Title 18, Section 1861 of the Social Security Act (Subsection dd), Medicare Benefit Policy Manual - Chapter 9 - Coverage of Hospice Services Under Hospice Insurance (PDF), Medicare Claims Processing Manual - Chapter 11 - Processing Hospice Claims (PDF), They get care from a Medicare-certified hospice, Their attending physician (if they have one) and the hospice physician certifies them as terminally ill, with a medical prognosis of 6 months or less to live if the illness runs its normal course, They sign an election statement to elect the hospice benefit and waive all rights to Medicare payments for the terminal illness and related conditions. ) Official websites use .govA Cheraghlou S, Gahbauer EA, Leo-Summers L, Stabenau HF, Chaudhry SI, Gill TM. Hospice and palliative medicine: new subspecialty, new opportunities. 2017 Apr;15(2):168-175. Permanent Resident Card or Alien Registration Receipt Card (Form I-551) 1. Dolin R, Hanson LC, Rosenblum SF, Stearns SC, Holmes GM, Silberman P. Factors Driving Live Discharge From Hospice: Provider Perspectives. A. Come January 1st, 2020 primary diagnosis codes will be categorized as either "acceptable" or "unacceptable". If there happen to be two hospice-appropriate diagnoses that contribute to the patients poor prognosis equally, requirements are that both be documented as the principal diagnosis, with sequencing between the two inconsequential. All Categories. The primary diagnosis must have one of twelve PDGM classifications according to home health care coding guidelines. Common diagnoses that are unacceptable primary diagnoses for Home Health under PDGM: . endstream endobj 434 0 obj <>/Metadata 20 0 R/Names 456 0 R/Outlines 36 0 R/Pages 429 0 R/StructTreeRoot 37 0 R/Type/Catalog/ViewerPreferences 457 0 R>> endobj 435 0 obj <>/MediaBox[0 0 612 792]/Parent 429 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 13/Tabs/S/Type/Page>> endobj 436 0 obj <>stream These 2020 ICD-10-CM codes are to be used for discharges occurring from October 1, 2019 through September 30, 2020 and for patient encounters occurring from October 1, 2019 through September 30, 2020. See the Data Table Report; Data_DX10 to reference the list of diagnosis codes applicable to the MCE Unacceptable principal diagnosis list and to reference the diagnosis codes that are exclusions due to current OPPS coding requirements. 2022 May 18. Diagnosis List is pointed to or linked as the primary diagnosis on the claim form, the associated claim line(s) will be . Condition Code (FL 18-28) H2 Discharge for cause (i.e. FOIA In the CY 2022 HH PPS Final Rule, it was stated that additional collaboration would be sought to further develop the methodology for the SFP through a Technical Expert Panel (TEP). Progression of disease via worsening status, symptoms, signs, laboratory results: B. This statistic lends risk to the common misconception that hospice services hasten death; however, in reality, it points to the issue that patients are often brought onto hospice services later than they were eligible. I13.0 Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease. For example, one of the codes they reclassified as "acceptable" Urinary tract infection, site not specified (N39.0) is often the primary diagnosis code. lock A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Widespread muscle denervation weakness, fasciculations, etc. The FTF encounter must document the clinical findings supporting a life expectancy of 6 months or less. MA enrollees who utilized the hospice benefit rose from 51.1 percent in 2015 to 53.2 percent in 2019. Here are four of her biggest recommendations. Identifying a Primary Hospice Diagnosis Determining a primary hospice diagnosis can be challenging when a patient has some, but not all, of the clinical indicators of a specific disease or condition. Variations Among Physicians in Hospice Referrals of Patients With Advanced Cancer. Medicare and Medicaid Services. 0 A person is considered terminally ill if their life expectancy is six months or less if the disease runs its normal course. Typically, there is an interprofessional team focus led by a physician medical director. mozzart jackpot winners yesterday; new mandela effects 2021; how to delete a payee on barclays app Information for Hospice Providers . Foreign passport that contains a As a contributor you will produce quality content for the business of healthcare, taking the Knowledge Center forward with your knowhow and expertise. ( Estimated glomerular filtration rate (GFR) <10 ml/min. Each patient must be seen as a unique person. patient/staff safety) 52 Discharge for patient unavailability, inability to receive care, or out of service area 85 Delayed recertification of hospice terminal illness (effective for claims received on or after 1/1/2017) CMS Pub. CMS establishes payment rates for each of the categories of hospice care described in 418.302 (b). Mehta A, Chai E, Berglund K, Rizzo E, Moreno J, Gelfman LP. In: StatPearls [Internet]. 0467469664; admin@thecleanex.com.au; The Cleanex is an NDIS Service Provider - NDIS Provider Number: 4050017476 These guidelinesprovided as a convenient tool and . This list is not all inclusive. Hospice Webinar Series 2021 Presenter: Sharon M Litwin, RN, BSHS, MHA, HCS-D Hospice Coding Refresher February 5, 2021 Objectives Coding Conventions & Guidelines Hospice Coding Primary Diagnosis/Terminal Illness Hospice Coding Secondary/Comorbid Diagnosis Disease Specific Criteria for Hospice 1 2 MeSH Hospice is a comprehensive, holistic program of care and support for terminally ill patients and their families. or Encounter for palliative care. Examining hospice enrollment through a novel lens: Decision time. Medical equipment. code 0651 or 0652. CMS now refers to them only as "acceptable" or "unacceptable" codes. In essence, most patients have multiple conditions, which could potentially be hospice-appropriate diagnoses. % hospice benefit, but if a donor organ is procured, the patient must be discharged from hospice. As the first year of PDGM has unfolded there have been many twists and turns in the new complexity of coding in home care. NHPCO published Facts and Figures just prior to the start of National Hospice and Palliative Care Month, marked each year in November. Certain codes require criteria that must be met before request are approved. In: StatPearls [Internet]. These 2020 ICD-10-CM codes are to be used for discharges occurring from October 1, 2019 through September 30, 2020 and for patient encounters occurring from October 1, 2019 through September 30, 2020. You can decide how often to receive updates. An official website of the United States government Alternatively, therapies might fall into the non-palliative category or be futile given the stage of the disease. 19. Cancer (29.6% - 336,307) Just as expected, cancer is still the number one diagnosis for hospice patients. Many diagnoses and conditions can impact the care of patients during the last stages of life. We are looking for thought leaders to contribute content to AAPCs Knowledge Center. Recurrent aspiration and/or aspiration pneumonia, Ideally, poor prognosis is supported by Neurologist evaluation within three months of hospice referral, Need for assistance with at least two activities of daily living, Functional impairment to the point of not being able to work or carry on normal activity. Often, these physicians who manage and monitor care during the length of service have additional training beyond residency by completing a dedicated fellowship, thereby earning board certification . Appropriate documentation is required for these codes. "Dementia in diseases classified elsewhere without behavioral disturbance," and 294.11/F02.81, "Dementia in diseases classified elsewhere with behavioral disturbance.". Privacy Policy | Terms & Conditions | Contact Us. The https:// ensures that you are connecting to the Clinical findings of malignancy with widespread, aggressive or progressive disease as evidenced by increasing sx, worsening lab values and/or evidence of metastatic disease 2. Stroke/Coma. Nearly 43 percent (42.7) of Hispanic Medicare beneficiary decedents and almost 41 percent (40.8) of Black Medicare beneficiary decedents enrolled in hospice in 2019. Hospice Eligibility Criteria Patient has a terminal illness with a life expectancy of 6 months or less CANCER Pt meets ALL of the following: 1. This website collects and uses cookies to ensure you have the best user experience. The 2023 edition of ICD-10-CM Z51.5 became effective on October 1, 2022. Sign up to get the latest information about your choice of CMS topics. 476 0 obj <>stream Cancer, heart disease, dementia, lung disease, and stroke are five common diagnoses seen in hospice patients. list of acceptable hospice diagnosis 2020 Typically, there is an interprofessional team focus led by a physician medical director. Overall, the hospice organizational agency is responsible for all patients in their care to ensure their satisfaction of eligibility criteria for hospice and that their services are medically necessary. Should have had at least one of the following in the 12 months preceding hospice referral: Poor prognosis supported by presence of comorbid conditions like COPD, CHF, CAD, DM, Parkinsons, stroke, renal failure, liver disease or AIDS, Not seeking dialysis or renal transplant OR discontinuing dialysis. Hospice organizations can assist in determining eligibility for patients suffering from terminal illnesses. Payment for general inpatient level of care is covered 100% by Medicare, Medicaid, and most commercial insurances. For example, list the medical condition that led to the debility (malignant neoplasm, end-stage renal disease, COPD). These same organizations can often provide thoughtful guided conversations with patients and their families about the benefits their services offer. The rates are established using the methodology described in section 1814 (i) (1) (C) of the Act and in accordance with section 1814 (i) (6) (D) of the Act. Primary Diagnosis Codes on the Hospice Claim . PMC 1830 0 obj <>stream Wang X, Knight LS, Evans A, Wang J, Smith TJ. This annual report provides a valuable snapshot of hospice access and care provision, but we never forget that behind the data points are people, added Banach. %%EOF Utilization of the hospice benefit remains slightly higher among individuals enrolled in Medicare Advantage (MA) plans than among traditional Medicare users, while the trendline for hospice usage continues to increase in both groups. Please enable it to take advantage of the complete set of features! StatPearls Publishing, Treasure Island (FL). Two 90-day periods followed by an unlimited number of subsequent 60-day periods. Data Show Growing Number of People Choosing Hospice and Decreasing Number of Cancer Diagnoses (Alexandria, Va) - The National Hospice and Palliative Care Organization (NHPCO) today published the 2021 edition of NHPCO Facts and Figures (PDF), a report produced annually to provide an overview of hospice care delivery in the U.S., with specific . Treasure Island (FL): StatPearls Publishing; 2022 Jan. Many of the diagnosis codes we had been utilizing in home health, are no longer allowed as a primary diagnosis, called unacceptable primary diagnoses. Secure .gov websites use HTTPSA lock 1779 0 obj <> endobj 8600 Rockville Pike Bookshelf Source: FY 2017 hospice claims data from the CCW, accessed and merged with ICD-10 codes on January 10, 2018. hb``` eap^5 The Median Length of Service (MLOS) was 18 days, which has changed little in the last fifteen years. In 2013, debility and adult failure to thrive were the first and sixth most common hospice claims-reported diagnoses, respectively, accounting for approximately 14 percent of all diagnoses. The patient owes a coinsurance payment when they got it during routine home care or continuous home care. Hospice/Hospice-Wage-Index.html.) Why this is the case will indeed require further research; however, what is known is that, by patients being eligible for months before the referral eventually is made, patients are missing out on the numerous benefits that a comprehensive hospice service can provide to its patient population. Charts 1 and 2 show that the average LOS varies by diagnosis. This site needs JavaScript to work properly. HHS Vulnerability Disclosure, Help Include a number of symptoms, including nausea and vomiting, dyspnea, persisting cough, fatigue, decreased cognition, diarrhea, and progressive pain, Include a number of clinical signs, including hypotension, edema, ascites, progressive weakness, new altered mental status, among others, Include a number of laboratory findings, including worsening pCO2/pO2/SaO2 values, worsening liver function tests, worsening tumor markers, and volatile sodium and potassium, among others, Chronic obstructive pulmonary disease (COPD), Neurologic disease (cerebrovascular accident, Parkinson disease, multiple sclerosis, amyotrophic lateral sclerosis), Refractory severe autoimmune disease (e.g., lupus or rheumatoid arthritis). The 2020 ICD-10-CM files below contain information on the ICD-10-CM updates for FY 2020. Medicare makes daily payments based on 1 of 4 levels of hospice care: Hospices may charge patients for these coinsurance amounts: For more information about quality data submission and reporting requirements, visit the Current Measures and Hospice Quality Reporting webpages. 0 ) Author. Cars &vehicles (9) Earn CEUs and the respect of your peers. Next year we mark the 40th anniversary of the passage of the Medicare hospice benefit legislation, and we must be actively planning for the next 40 years. There must be a complete evaluation of the totality of their conditions for each patient, including hospice-appropriate diagnoses and treatment plans. 51.6 percent of all Medicare decedents were enrolled in hospice at the time of death in 2019. 0Wtt0r i $*43+ LL%```ELBM|Zt;!.c`b: 4+V2301 `, Y4k Examining hospice enrollment through a novel lens: Decision time. Originally, when the Home Health Groupings Model (HHGM) was first proposed back in July 2017, CMS provided a table of all ICD-10 codes (64,676 in all) and mapped each code to the applicable HHGM clinical category, including the codes indicated as "Questionable . ICD-10-CM Diagnosis Code O34.7. Jones BW. Accessed June 23 . and transmitted securely. After the second, 90-day period, the recertification associated with a hospice patients third benefit period, and every subsequent recertification, must include documentation that a hospice physician or a hospice nurse practitioner had a face-to-face (FTF) encounter with the patient. Business Opportunities (5) . PPS <70% 3. N)~(-mmZs Here are the top 20 most frequently hospice claims-reported diagnoses for 2017. Click here to access the list of ICD-10-CM Diagnosis codes that have a PDGM classification. [Updated 2022 Aug 1]. hbbd```b``>V f[H0 "YH0Vc&"`5`'l; $7M $Rb3X0 l@_H6(CW? 9/ von Gunten CF, Sloan PA, Portenoy RK, Schonwetter RS; Trustees of the American Board of Hospice and Palliative Medicine. Medicare makes this daily payment regardless of the number of services provided on a given day, including days when the hospice provides no services. The basic foundation of hospice is offering palliative and complex symptomatic management to those with a life expectancy of six months or less. Variations Among Physicians in Hospice Referrals of Patients With Advanced Cancer. Home > Medical Services > Hospice > Referrals & Admission > Hospice Eligibility Guidelines by Diagnosis. While the assessment of appropriate hospice diagnoses can be confusing for healthcare providers that are not required to stay abreast of the literature constantly, hospice physicians and organizations can offer valuable services to help answer questions and provide guidance. Research has shown that hospice does improve the quality of life in patients. Refer to the Medical Policies page to access the hospice LCD. Epub 2009 Jan 29. Interventions for Reducing Hospital Readmission Rates: The Role of Hospice and Palliative Care. The physician or other authorized ordering party is responsible for providing correct codes that support the medical necessity of each test ordered for the diagnosis and treatment of the individual patient. This includes care provided in the patients own home, an assisted living facility, nursing home, or other congregate living facility. The average Lifelong Length of Stay (LLOS) for Medicare patients enrolled in hospice in 2019 was 92.6 days. Am J Med. Hospice care changes the focus to comfort care (palliative care) for pain relief and symptom management instead of care to cure the patients illness. Over the years, there have been changes in the diagnosis patterns among Medicare hospice enrollees largely due to changes in coverage. In the new PDGM (Patient Driven Groupings Model) payment model effective 2020, the Primary Dx will be very important in order to determine what payment group your claim will fall under. official website and that any information you provide is encrypted Patients will be considered to be in the terminal stages of stroke or coma (life expectancy of six months or less) if they meet the following criteria: Stroke. Buss MK, Rock LK, McCarthy EP. Learn about hospice guidelines for your patients with end-stage heart disease, including CHF, and download a PDF of these guidelines for easy reference. But for the past five years, neurologically based diagnoses have topped the list. This document outlines the specifications for reporting diagnosis and procedure codes in T-MSIS claims files. The Nomination Form is available at this link: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Spotlight. Share sensitive information only on official, secure websites. (Alexandria, Va) The National Hospice and Palliative Care Organization (NHPCO) today published the 2021 edition of NHPCO Facts and Figures (PDF), a report produced annually to provide an overview of hospice care delivery in the U.S., with specific information on hospice patient characteristics, location and level of care, Medicare hospice spending, hospice provider characteristics, and more. The patient does not owe any coinsurance when they got it during general inpatient care or respite care. Goy ER, Bohlig A, Carter J, Ganzini L. Identifying predictors of hospice eligibility in patients with Parkinson disease. -Fractures as a primary diagnosis for hospice General Coding Guidelines Signs and Symptoms Codes that describe symptoms and signs, as opposed to diagnoses are acceptable for reporting purposes when a related definitive diagnosis has not been established (confirmed) by the provider. The .gov means its official. Understanding Palliative Care and Hospice: AReview for Primary Care Providers. On Friday, November 5, NHPCO is encouraging all hospice providers and supporters to participate in the annual Social Media Action Day to increase visibility of hospice and palliative care and share the benefits. ICD-10-CM Diagnosis Code O32.4. Sign up to get the latest information about your choice of CMS topics. Diagnoses might change and need to be documented, with additions and deletions, as a patient progresses through the terminal stages of their conditions. Restricting Symptoms Before and After Admission to Hospice. There are over 43,000+ primary Dx codes. X0Lj*RA^?_ Q~x(V(d q C%Be`~} H /H33b|Ey'Bf fN@|{J3|,gw+G$XliF ,v`H ]PU W~D Permanent 5% cap on negative . Hospice care agencies. Enrollment into hospice service is not as simple as a patients primary physician making a prognosis of fewer than six months to live. As recently as 2007, cancer continued to be the leading principal diagnosis of those receiving care. allegiant flights from sioux falls to mesa az; list of acceptable hospice diagnosis 2020. hb``Pd``: $zcP#0p4 )B1) :Jz\VYXjX02(aQ~qGW#ww/~Ug31!bb%#2YQ ! Patients have to meet all of Medicare's hospice eligibility criteria, which include: 1. http://creativecommons.org/licenses/by-nc-nd/4.0/. Accessibility Effective October 1, 2014, these diagnoses are no longer permitted as principal diagnosis codes on hospice claims. Share sensitive information only on official, secure websites. Twenty-five percent of beneficiaries received care for five days or less, and 50 percent received care for 18 days or less. Official websites use .govA The specifications in the technical instructions provide an explanation on how the data elements should be populated to ensure that diagnoses and procedures covered by Medicaid are accurately reported in the state's T-MSIS file submission. 1.55 million Medicare beneficiaries received hospice care in 2018, an increase of 4 percent from the previous year. Revised February 2022 . Progressive disease leading to worsened Karnofsky Performance Status or Palliative Performance Score.[7]. .gov Centers for Disease Control and Prevention National Center for Health Statistics. Share sensitive information only on official, secure websites. These codes are only to be used when the medical record, at the time of the encounter, is insufficient to assign a more specific code. While cancer is still the top terminal illness, the figure has been declining for several years now due to advances in the treatment of the disease. 2017 Feb;92(2):280-286. 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