Local Coverage Article

Hospice: Documenting Weight Loss for Beneficiaries with Non-Neoplastic Conditions

A53056

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Contractor Information

Article Information

General Information

Article ID
A53056
Original ICD-9 Article ID
A50424
Article Title
Hospice: Documenting Weight Loss for Beneficiaries with Non-Neoplastic Conditions
Article Type
Article
Original Effective Date
10/01/2015
Revision Effective Date
10/22/2015
Revision Ending Date
N/A
Retirement Date
N/A
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Article Guidance

Article Text
Weight has long been used as a measure of nutritional status. Both absolute body weight and changes in body weight have prognostic significance. The documentation of absolute body weight provides information at a specified point in time, while changes in body weight allow clinicians to gauge a given patient's response to treatment over time.

If hospice organizations record “percent weight loss” as an indicator of nutritional status, Palmetto GBA expects to see supporting documentation of the absolute weights used to calculate the percent decrease. The reporting of absolute weights strengthens documentation of percent change in weight over time (e.g., > 10% weight loss over the last six months with weight decreasing from 110 pounds to 95 pounds). Palmetto GBA encourages hospice providers to include absolute weights in their responses to Additional Documentation Requests (ADRs).

Unsupported percent weight loss in the medical record may result in a denial if other documentation does not lend support to impaired nutritional status.

Coding Information

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

CodeDescription
081x Hospice (non-Hospital based)
082x Hospice (hospital based)

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

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CPT/HCPCS Codes

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ICD-10-CM Codes that are Covered

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ICD-10-CM Codes that are Not Covered

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Revision History Information

Revision History DateRevision History NumberRevision History Explanation
10/22/2015 R3 Annual Validation
10/01/2015 R2 Under Bill Type Codes added 81X and 82X for Hospice. Annual validation.
10/01/2015 R1 Article validation

Associated Documents

Related National Coverage Documents
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Statutory Requirements URLs
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Rules and Regulations URLs
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CMS Manual Explanations URLs
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Public Versions
Updated On Effective Dates Status
10/16/2015 10/22/2015 - N/A Currently in Effect You are here
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

Keywords

  • Weight Loss
  • Absolute Weight