Home Health ICD-9/ICD-10 Alert

Question: When would I use 790.92 (abnormal coagulation profile) versus V58.61 (long term [current] use of anticoagulants) or V58.83 (encounter for therapeutic drug monitoring)?

Answer: You should use 790.92 only when there is in fact an abnormal coagulation finding. Code V58.61 (Long term [current] use of anticoagulants) is appropriate if a patient is new to Coumadin therapy, and you are providing home care to monitor the patient's medication dosage, assess the drug's effects and side effects, educate the patient about them and draw labs to assist in titration of the dosage.

You would use V58.83 (Encounter for therapeutic drug monitoring) in addition to the specific V code for anticoagulants (or NSAIDs, antibiotics, steroids, etc.) for teaching, assessing and monitoring the effects and side effects. The instructions in the ICD-9 CM manual at V58.83 state, "use additional code for any long-term (current) drug use (V58.61-V58.69)."