# V58.44 - Aftercare following organ transplant



## seattlegrace (Sep 4, 2009)

In April of 2007 there was a thread which involved code V58.44.  The question was, "If the patient visits the doctor, post kidney transplant, and the patient is doing well with no problems, what is a correct diagnosis to bill for the current visit?

Two responses were to use V58.44.  I agree.  However, what is everyone's opinon in how this aftercare code should be used?  The official coding guidelines indicate that aftercare codes "cover situations when the initial treatment of a disease or injury has been performed and the patient requires continued care during the healing or recovery phase, or for long-term consequences of the disease.  The aftercare V code should not be used if treatment is directed at a current, acute disease or injury. The diagnosis code is to be used in these cases."

So if a patient comes in for his routine maintenance six years following transplant, without problems, would you still report V58.44?  However, what about if the kidney is functioning fine, but the doctor documents diabetes and/or hypertension.  In such cases would you report 250.00 and/or 401.9, rather than V58.44 since those conditions can be so closely related to kidney disease?  Does matter how many years have passed since the transplant?

Thanks for any input/rationale.


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## ASH527 (Sep 4, 2009)

Look at pages 16 and 17, coding guidelines section of the ICD-9 book it explains aftercare,followup and history codes  -If the patient isn't having any problems from the transplant I would code V42.0 and query the physician regarding the diabetes and hypertension, were they the main problems for the visit.


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## seattlegrace (Sep 4, 2009)

Disregard - I accidentally sent this twice.  I am new here.


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## seattlegrace (Sep 4, 2009)

So you wouldn't report V58.44 at all?


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## seattlegrace (Sep 4, 2009)

I had one gal come in for routine follow-up six year post transplant.  She had no chronic conditions.  V42.0 cannot be first-listed.  So I started considering V58.44.  I didn't know what else to consider as the first-listed code.


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