Home Health ICD-9/ICD-10 Alert

Question: Our patient had a traumatic injury to her knee a month ago. She had arthroscopic surgery and was healing well at first, but now she has a septic knee with drainage through one of the arthroscopy ports. We are seeing her for IV antibiotics and lab draws for peak and trough. Should I report the septic knee as primary or is the post-operative infection my primary diagnosis? 


Arizona Subscriber

Answer: Code for a septic knee joint with 711.06 (Pyogenic arthritis, lower leg). If the diagnosis is actually just an infection of the surgical wound, the correct code is 998.59 (Other postoperative infection). Assuming that the diagnosis of septic knee is correct, code your patient:

• M0230a 711.06 (Pyogenic arthritis, lower leg);
• M0240b V58.81 (Fitting and adjustment of a vascular catheter);
• M0240c V58.83 (Encounter for therapeutic drug monitoring); and
• M0240d V58.62 (Long-term [current] use of antibiotics).