Home Health ICD-9/ICD-10 Alert

Question: We have a patient who has had multiple sclerosis for 15 years. We see this patient for management of her neurogenic bladder. She is experiencing urinary retention due to the neurogenic bladder, and we are managing this with a Foley catheter. Our nurse visits this patient every three weeks to change and care for the catheter and to watch for signs of a urinary tract infection (UTI). How should we code for this care?


Indiana Subscriber


Answer: Apply the proximate-condition-versus-underlying-diagnosis concept to this scenario to avoid coding a long-term chronic condition first when the focus of the care (the proximate reason) is the neurogenic bladder. Urinary retention is integral to neurogenic bladder, so you shouldn't code for it separately. Code as follows:

• M0230a: V53.6 (Fitting and adjustment of other device; urinary devices);

• M0240b: 596.54 (Neurogenic bladder NOS); and

• M0240c: 340 (Multiple sclerosis).

Leave M0245 blank for this patient because the underlying diagnosis to the V code is the neurogenic bladder, which is not a case mix diagnosis.

Unless otherwise indicated, reader questions were answered by Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, consultant and principal of Selman-Holman & Associates in Denton, TX.