# Help with aftercare coding



## ruhood (Apr 16, 2009)

I could use some help with understanding the use of aftercare codes. I believe I understand the use of the codes during the global period. After the global period, what do I look for in the documentation to let me know that I should use an aftercare code? Does the note need to say that the pt. is there for followup of fracture or surgery? How long after fracture care or surgery would aftercare apply?

I would also appreciate information regarding any references that would be helpful in ortho coding.

Thanks,
Ruth Hood, CPC
rh.hood@yahoo.com


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## ruhood (Apr 18, 2009)

Anyone have anything to offer on this subject?  I would greatly appreciate it.  Thanks!


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## pmaho (Apr 20, 2009)

*Aftercare code*

We frequently use v54.01 when hardware is removed even though the date of surgery to remove the hardware is not within global of the initial surgery.
Of course, this is just one example, but regardless, I try to use an aftercare code for surgeries regardless of global.

Patrick


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## lnagai (Apr 20, 2009)

*aftercare codes*

I found the following information in the ICD-9 official guidelines for coding and reporting:  Fractures are coded using the aftercare codes (v54.0, V54.2, V54.8 or V54.9) for encounters after the patient has completed active tx of the fx and is receiving routine care for the fx during the healing or recovery phase.  Examples of fx aftercare are: cast change or removal, removal of external or internal fixation device, medication adjustment, and follow up visits following fx treatment.  Examples of active tx are: surgical tx, emergency dept. encounter, evaluation and tx by a new physician.  Hope this helps.

L.Nagai, CPC


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## encoderpro (Apr 20, 2009)

*V-Codes*

These codes are used to describe circumstances, other than a disease or injury, that are the reason for an encounter with the health care delivery system or that have an influence on the patient's current condition i.e. aftercare; such as rehab procedures. Depending on how there sequenced they can explain the reason for the encounter...Such as patient presenting for physical therapy status post  a TKR...V43.65. If they are sequenced second, they identify a circumstance that affects the patients health status but is not in itself a current illness.

EB


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## Sandyv (Jun 15, 2009)

*V-Codes*

In your example of the knee replacement, and PT aftercare:  Is V43.65 the only code you would use for Medicare and/or non-Medicare?

SandyV


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## ammontagano (Jun 15, 2009)

V43.65 can only be used as a secondary dx.  If the pt is still in his global period, code V54.81 as primary dx, if the global is over, use V67.09 as the primary dx.


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## lfoote_25 (Jun 15, 2009)

v54.89 is that specifically for fractures only or would it be accepted after a global for tka and such?


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## ammontagano (Jun 16, 2009)

V54.89 is for "Other Orthopedic Aftercare", we use it for all of our surgeries(fusions, shoulders, meniscectomies, etc), we use V67.4 for fx, the description is "F/U Tx of healed Fx"


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## mitchellde (Jun 16, 2009)

Many years ago I read an article that really helped me, aftercare it stated is for use when some type of management is being directed toward the pateint and they are best paired with V codes stating the type of aftercare rendered such as attention to device or removal of sutures.  Follow-up on the otherhand can be viewed as a simple surveilance encounter for the physician to make certain that all is well with the patient.  
I hope this is of assistance for you.


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