Iowa Medicaid Hospice Provider Manual ch. III § D.1

The hospice provider is to report diagnosis coding on the hospice claim

required by ICD-10 coding guidelines. The principal diagnosis reported on

the claim is the diagnosis most contributory to the terminal prognosis.

A list of nonreimbursable ICD-10 codes is available below:

NOT REIMBURSABLE AS HOSPICE ICD-10 PRIMARY DIAGNOSES

Coding

Guideline

ICD-10

Code ICD-10 Diagnosis

Dementia –

Code the associated neurological

or physical

condition as

primary.

F0390 Unspecified dementia without behavioral

disturbance

F0391 Unspecified dementia with behavioral disturbance

F05 Delirium due to known physiological condition

F0150 Vascular dementia without behavioral disturbance

F0151 Vascular dementia with behavioral disturbance

F0280 Dementia in other diseases classified elsewhere

without behavioral disturbance

F0281 Dementia in other diseases classified elsewhere

with behavioral disturbance

Coding

Guideline

ICD-10

Code ICD-10 Diagnosis

Unspecified

conditions

F0390 Unspecified dementia without behavioral

disturbance

F0391 Unspecified dementia with behavioral disturbance

I50.9 Heart failure, unspecified

I50.20 Unspecified systolic heart failure

I50.30 Unspecified diastolic heart failure

I50.40 Unspecified combined systolic and diastolic heart

failure

N18.9 Chronic kidney disease, unspecified

N19 Unspecified kidney failure

J96.91 Respiratory failure, unspecified with hypoxia

J96.92 Respiratory failure, unspecified with hypercapnia

Acute

respiratory

failure –

Acute is defined

as a rapid onset

and a short,

severe course.

Chronic respiratory required

for terminal

diagnosis.

J95.821 Acute post procedural respiratory failure

J9600 Acute respiratory failure, unspecified whether

with hypoxia or hypercapnia

J9601 Acute respiratory failure with hypoxia

J9602 Acute respiratory failure with hypercapnia

J9690 Respiratory failure, unspecified, unspecified

whether with hypoxia or hypercapnia

Chronic kidney

disease –

Renal failure

required for

terminal

diagnosis.

N18.1 Chronic kidney disease, Stage I

N18.2 Chronic kidney disease, Stage II (mild)

N18.3 Chronic kidney disease, Stage III (moderate)

N18.4 Chronic kidney disease, Stage IV (severe)

N18.5 Chronic kidney disease, Stage V

Symptoms,

signs and ill-defined

conditions

R00.00

– R99

All codes included in ICD-10, Chapter 16,

Symptoms, Signs, and Ill-Defined Conditions