Z66 Do not resuscitate

Name of the Condition

• Do not resuscitate

Summary

This code represents a documented patient preference to decline resuscitative efforts in the event of cardiac or respiratory arrest. It is a formal medical directive indicating that healthcare providers should not perform cardiopulmonary resuscitation (CPR) or other life-sustaining measures if the patient’s heart or breathing stops. The decision is typically made in advance, often as part of advance care planning, and is intended to align care with the patient’s wishes.

Causes

Not applicable, as this code reflects a patient’s voluntary decision rather than a condition caused by external factors.

Risk Factors

• No specific risk factors apply, as this is a personal preference rather than a health-related risk. However, individuals with chronic or terminal illnesses may be more likely to consider or document such preferences.

Symptoms

Not applicable; this code describes a patient’s directive, not a condition with symptoms.

Diagnosis

The process involves documenting the patient’s explicit request to forgo resuscitation. This is typically done through a written advance directive, such as a do-not-resuscitate (DNR) order, which is signed by the patient (or their legal representative) and a healthcare provider. The documentation must clearly state the patient’s wishes and be part of the medical record.

Treatment Options

Not applicable; this code does not represent a treatment but rather a directive to withhold resuscitative measures. However, other aspects of care, such as comfort measures or palliative care, may still be provided based on the patient’s overall care plan.

Prognosis and Follow-Up

There is no associated prognosis, as this code reflects a preference rather than a medical condition. Follow-up may involve periodic review of the DNR order to ensure it remains consistent with the patient’s wishes, especially if their health status changes.

Complications

• No direct complications arise from the DNR order itself. However, miscommunication or failure to document the order properly could lead to unintended resuscitation attempts, which may conflict with the patient’s wishes.

Lifestyle & Prevention

• Not applicable, as this is a medical directive rather than a condition influenced by lifestyle factors.

When to Seek Professional Help

• Patients or their families should consult with healthcare providers to discuss and document DNR preferences, especially if the patient has a chronic or life-limiting illness. Legal or ethical guidance may also be sought to ensure the directive is valid and aligned with local regulations.

Tips for Medical Coders

• This code is used to document a patient’s documented preference to decline resuscitation. Coders should verify that the medical record includes clear, signed documentation of the DNR order, including the patient’s name, date, and signature (or legal representative’s signature if applicable). The code should be applied when the DNR status is documented and relevant to the encounter, ensuring it is not confused with other advance directives (e.g., do-not-intubate orders). Documentation must reflect the patient’s explicit request and be part of the official medical record.