Home Health ICD-9/ICD-10 Alert
Look to Aftercare for Pathologic Fracture
Question: Our patient has a healing pathologic fracture of her right femur due to senile osteoporosis. We will be providing skilled nursing, physical therapy, and occupational therapy. She also had a vertebral pathologic fracture due to her senile osteoporosis 1 year ago. How should we code for her?
North Carolina Subscriber
Answer: Code for this patient as follows:
Your focus in this multi-disciplinary case is aftercare for your patient’s pathologic hip fracture, so you’ll list V54.23 in M1020a, paired with 733.14 in M1024.
Case mix: Acute fractures are the one condition you’re still able to report in M1024, but you won’t earn any case mix points for this patient. That’s because she doesn’t also have a pressure ulcer and isn’t receiving IV or parenteral nutrition at home. But listing 733.14 may impact your risk adjustment.
Follow this with 733.01 for your patient’s senile osteoporosis. Finally, list a history code for her vertebral pathologic fracture because it will impact the care your agency provides.
In ICD-10, you won’t list aftercare codes for fracture care provided in home health. Instead, you’ll list the fracture code with seventh character “D” to indicate subsequent encounter. So, you would list the following codes for this patient:
Home Health ICD-9/ICD-10 Alert
- Coding 101:
Let 3 Questions Guide Your Diabetes Coding
Mind the etiology/manifestation sequencing guidelines. Your patient’s diabetes impacts the care you provide and the [...] - Know the Points for Diabetes
Diabetes is a case mix diagnosis, allowing you to earn additional reimbursement. But you’ll also [...] - Coding How To:
Take Care with Diabetic Assumptions
Know when to look for cause-and-effect documentation. While you generally can’t assume your diabetic patient’s [...] - ICD-10:
Navigate the Alphabetic Index Carefully for Diabetes in ICD-10
Welcome five more specific diabetes categories. Diabetes coding gets a thorough make-over in ICD-10, but [...] - ICD-10 Update:
Prep Your Budget -- and Your Software -- for the ICD-10 Conversion
Caps lock is one thing you won’t have to worry about under ICD-10. If you’ve [...] - You Be the Coder:
Report Details for Non-Healing Amputation
Question: Mrs. White, an 89-year-old female was admitted to home health following an amputation of the [...] - ICD-10 Coverage
You’ve probably noticed our new name, Home Health ICD-9/ICD-10 Alert. We’ve changed our name, but [...] - Reader Question:
Specificity Pays Off with Osteoarthrosis
Question: Our patient has osteoarthrosis of the knees and the hips. We will be providing physical [...] - Reader Question:
Look to Aftercare for Pathologic Fracture
Question: Our patient has a healing pathologic fracture of her right femur due to senile osteoporosis. [...]
