Home Health ICD-9/ICD-10 Alert

READER QUESTION:

Gain Points For Fracture Care

Question: Our patient was referred to us for rehabilitation for lack of coordination because of a hip fracture. Which should I code as primary -- lack of coordination (781.3) or aftercare for the open reduction internal fixation (ORIF) of the hip fracture (V54.13)? Will coding one or the other give me a higher reimbursement rate?


South Dakota Subscriber


Answer: You can list either the lack of coordination or the aftercare for the healing traumatic fracture as primary, but V54.13 may be the best choice. If you sequence V54.13 first, then you can list either the lack of coordination or the acute code for the fracture itself in M0245 for case mix points. Both are worth 11 points, so they result in the same reimbursement.

 

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