If you are a newbie to home health coding or a seasoned professional, you may still have some trouble comprehending the proper use of M1024. What exactly is M1024? M1024 is used to prevent the loss of case mix points when an underlying case mix diagnosis is displaced by a V-code.
A diagnosis can only be placed in M1024 when there is a V-code listed in M1020a or M1022b-f. This slot is optional, therefore, agencies are not required to code a numeric diagnosis in M1024 if a V-Code replaces a case mix diagnosis code. Diagnoses listed in M1024 can only be a case-mix diagnosis that is resolved or a diagnosis that is part of one of the case-mix loss groups. The case-mix loss groups are Diabetes, Skin 1, and Neuro 1. If a V code is listed as primary and it is displacing a diagnosis in one of these categories, the diagnosis should be listed in M1024a and also in M1022. The diagnoses are termed case-mix loss groups because the diagnosis are given more points when reported as a primary diagnosis opposed to a secondary diagnosis.
Use the following guidelines to help you determine whether or not you should place a diagnosis in M1024a:
- *M1020 (primary diagnosis) is an approved V-Code
- The V-code displaces a numeric case-mix diagnosis that is resolved
- If the numeric case mix diagnosis is not resolved, it is included within on of the HH PPS case-mix loss groups:
- Diabetes
- Skin 1-Traumatic wounds, burns, and post-operative complications
- Neuro 1-Brain Disorders and Paralysis
*In order to determine whether or not the V code which is displacing a case-mix diagnosis is an approved V code, you need to refer to this V Code Table. (If the V code in question is not listed in this table, there is no need to enter a diagnosis in M1024)
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