Home Health ICD-9/ICD-10 Alert

Question: We have a patient who has been referred to home health for IV antibiotics after surgery for removal of a bone lesion secondary to chronic osteomyelitis of the foot. What is the best way to code this patient?

Answer: If the focus of the care is the surgical aftercare, you would code that first. However, since you have indicated that the patient is on IV antibiotics, we may assume that the osteomyelitis is still present. In that case, code the osteomyelitis first and do not use the V code for surgical aftercare since the care is not routine. Code for this patient as follows:

• M0230a: 731.1 (Osteitis deformans and osteopathies associated with other disorders classified elsewhere, osteitis deformans in diseases classified elsewhere)

• M0240b: Code the organism, if known

• M0240c: V58.81 (Other specified procedures and aftercare, fitting and adjustment of vascular catheter)

• M0240d: V58.62 (Long-term [current] drug use, long-term [current] use of antibiotics).

Remember: If the care is routine, you should code aftercare first with V58.78 (Aftercare following surgery to specified body systems, not elsewhere classified, aftercare following surgery of the musculoskeletal system, NEC) and place 731.1 in M0245.

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