Home Health ICD-9/ICD-10 Alert

Question: Is V58.83 a code for medical management? I have been using both V58.83 and the V58.6x codes when we are filling our patients' med boxes.

-- Texas Subscriber

Answer: There is no ICD-9-CM code for medical management. Also note that filling medication boxes is not skilled care. There are two problems in using the codes you suggest:

First: V58.83 (Encounter for therapeutic drug monitoring) is for assessment of the effectiveness of the medication. In fact, Coding Clinic states that V58.83 is for evaluation of lab data for effectiveness of the medication. An example would be drawing blood for evaluation of therapeutic blood levels. For this reason, you should not sequence V58.83 as primary because venipuncture, although a skilled service, cannot be the qualifying skill for home care.

Second: The V58.6x codes cannot be used as primary and are actually status codes. The V58.6x codes mean the patient is taking the medication, not that you are doing anything with the medication. You may use them to indicate when you expect the patient to take a medication long-term or if the patient takes the medication prophylactically. Do not use them for every medication the patient is on.