August 10 2026
OASIS Answers
Categories: HOPE

Accurately Completing I0010 – Principal Diagnosis on the HOPE

by Kerry Termine, DPT, HCS-D, COS-C, CHS-C

CMS Clarifies HOPE Comorbidities Coding Guidance

On May 7, 2026, CMS released the Hospice Quality Reporting Program (HQRP) Frequently Asked Questions (FAQ). In this resource there were updates and clarifications to guidance involving the Hospice Outcomes and Patient Evaluation (HOPE) tool. There was also valuable information related to HQRP quality measures, data submission requirements, and reports.

Prior to the release of the Hospice FAQ, HOPE coding guidance instructed providers to, “Check all comorbid and/or coexisting diseases or medical conditions that are addressed in the plan of care or that have the potential to impact the plan of care” for I0010 – Principal Diagnosis.

This statement did not clearly address how to answer I0010 when the patient does not have any comorbid and/or coexisting diseases or medical conditions, apart from their terminal diagnosis, that are being addressed in the plan of care.

The Hospice FAQ clarified that there is no required minimum for the Comorbidities and Co-existing Conditions section of the item. It is acceptable for providers to check all that apply or to check none if the patient does not have any comorbid and/or co-existing diseases or medical conditions that are being addressed in the plan of care.

Learn More About HOPE Guidance and CMS Requirements

To review this guidance and other information, the Hospice FAQ can be accessed through the Hospice Quality Reporting Training and Education Library webpage.

For more information on HOPE Guidance, the HOPE in Action Training for Hospice providers focuses on the essential elements that drive HOPE accuracy, compliance, and confidence. Information on this training can be found here.

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