Home Health ICD-9/ICD-10 Alert
Know When to List Additional Codes
Question: What is the proper interpretation of the "use additional code to identify cerebral atherosclerosis" note found in the tabular list for 290.4x (Vascular dementia)? Does this mean that we should always list 437.0 (Cerebral atherosclerosis) in addition to 290.4x when coding for vascular dementia, or is including this additional code only appropriate when cerebral atherosclerosis is documented? Massachusetts subscriber Answer: "Use additional code" instructions ask you to list an additional code if you have documentation that it is an appropriate additional diagnosis. There are cases where this note indicates a manifestation/etiology pair, but that's not the case with the diagnoses you're asking about. Atherosclerosis is the most common cause of vascular dementia, but it is not the only cause. Hypertensive changes, anoxic brain damage, ischemic white matter damage, and hypotensive brain damage can all result in vascular dementia. The "code first the associated neurological condition" note at the beginning of the 290.xx category creates the same kind of confusion. Often, specifics regarding the associated neurological condition are not available. You may code the 290.xx codes without the associated neurological condition if that information is not available. The 290 codes are not manifestation codes so if the underlying condition is not documented, report the appropriate 290 code according to the physician's description.
Home Health ICD-9/ICD-10 Alert
- Coding How-To:
Avoid These V Code Errors and Keep Your Reimbursement Accurate
Watch your sequencing or pay the price. The Centers for Medicare & Medicaid Services is [...] - ICD-10:
Watch for Two Kinds of 'Excludes' in ICD-10 Aftercare Codes
New notes clear up blurred exclusion instructions. While many coding conventions will remain the same [...] - Coding 101:
Sequencing Secrets Help You Code Late Effects with Ease
Late effect of CVA turns guidelines upside down. Unsure of when and how to report [...] - Look to Sub-terms for Late Effects
Mistake: You won't find what you need to code a late effect if you search [...] - Education:
Need to Brush Up On Late Effects and Risk Adjustment? We've Made it Easy
Check out upcoming Eli audioconferences on late effects coding and the impact of risk adjustment [...] - You Be the Coder:
Test Your V code Expertise
Question: Think you have V codes down pat? Try coding these scenarios from Shirley Kucirek, [...] - Reader Question:
Cover Hypothyroidism with Graves Disease Code
Question: What is the proper way to code a patient who was diagnosed with and [...] - Reader Question:
Look to Aftercare for Joint Revision
Question: Our patient had aseptic loosening of the tibial component of his knee replacement. He [...] - Reader Question:
Know When to List Additional Codes
Question: What is the proper interpretation of the "use additional code to identify cerebral atherosclerosis" [...]
