Home Health ICD-9/ICD-10 Alert

Take note of injury cause to choose the right code.

While the ICD-10-CM code set does close the door on aftercare coding for injuries and rehabilitation, that doesn’t mean you’ll never list an aftercare code.

Aftercare codes in ICD-10-CM Chapter 21, "Factors influencing health status and contact with other health services" include codes such as Z47.81 (Encounter for orthopedic aftercare following surgical amputation), Z48.815 (Encounter for surgical aftercare following surgery on the digestive system), and Z47.1 (Aftercare following joint replacement surgery).

Take note: At category Z47 (Orthopedic aftercare) is an Excludes1 note that says "aftercare in healing fracture — code to fracture with 7th character D," points out Ann Zeisset, RHIT, CCS, CCS-P, AHIMA-Approved ICD-10-CM/PCS Trainer with Ann Zeisset Consulting in Trenton, Ill.

Coding scenario: You are providing aftercare for a patient who had a left hip replacement due to arthritis of the hip. List Z47.1 (Aftercare following joint replacement surgery) and Z96.642 (Presence of left artificial hip joint), Zeisset says.

But aftercare codes won’t be appropriate for all of your hip replacement patients. For example, suppose your patient has a left hip replacement displaced intertrochanteric fracture of the hip. Your agency is providing aftercare of the routine healing fracture. List S72.142D (Displaced intertrochanteric fracture of left femur with subsequent encounter for closed fracture with routine healing), Zeisset says.