Home Health ICD-9/ICD-10 Alert

Use V57.89 for multiple therapies.

If you've been using V57.x codes as if they were procedure codes, it's time to shift your thinking.

The V57 category (Care involving use of rehabilitation procedures) codes are intended to be used as "admission for" codes, says Sue Bowman, RHIA, CCS, director of coding policy and compliance with the American Health Information Management Association (AHIMA) in Chicago.

AHIMA, the American Hospital Association, the Centers for Medicare & Medicaid Services, and the National Center for Health Statistics saw the code being misused. Agencies assigned codes from the V57 category as though they were procedure codes intended to indicate that a patient was receiving therapy. Noting this error, the organizations decided to clarify the category's intended use by moving it to "first-listed only" status in the V code table, says Bowman.

Use V57 category codes when the reason for admission to a health care setting is for the purpose of receiving rehabilitative therapy, explains Bowman.

How to do it: One coding expert offers the following suggestions for coding from the V57 category:

• If your patient is being admitted for physical therapy, code V57.1 (Other physical therapy) first.

• If your patient is being admitted after a hip replacement for therapy only, code V57.1 first. 

• If your patient is being admitted after a fracture for physical therapy and occupational therapy, code V57.89 (Multiple training or therapy) first.

• If the patient is being admitted for home care, which may include therapy, do not code V57.x at all, suggests the coding expert. It doesn't matter if therapy is the primary focus of care, do not use the V57.x code, she says.

Watch for: If your policy is to have the RN complete the OASIS for an otherwise therapy-only client, don't assume you have a multidisciplinary case. The client is being admitted for therapy, not for nursing and therapy.