Home Health ICD-9/ICD-10 Alert

Mistake: You won't find what you need to code a late effect if you search under "syndrome" or "complication" in the alphabetic index of your coding manual. And it's wishful thinking if you expect to find a handy section that includes all the late effects codes in the tabular list.

To find the right late effect code, look in the alphabetic index under "late effects." Then look through the subterms to find the diagnosis that fits your patient.

For example: Your patient has myelitis as a late effect of polio. When you get to the sub-term "poliomyelitis, acute" in the alphabetic index, it says "(conditions classifiable to 045) 138." But don't jump to the conclusion that 045.xx is your code -- it's actually the code for acute poliomyelitis which you would use to report a patient who currently has polio. Instead, check the code series following the parentheses to make sure you have found the right code for your patient. In this case, 138 (Late effects of acute poliomyelitis).

Think of this entry in the alphabetic index as a note indicating "if you coded it like this as an acute condition with 045.xx, then code for it like this as a late effect with 138, " says Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, consultant and principal of Selman- Holman & Associates and CoDR -- Coding Done Right in Denton, Texas.

Tip: You will almost never use the code for the acute phase of an illness or injury that led to the late effect in conjunction with a code for the late effect. The one exception in which you can code the acute injury along with the late effect of the same injury is when coding for burns, Selman-Holman says. This exception is the result of another guideline which states that you must code a non-healing burn as an acute burn.