Home Health ICD-9/ICD-10 Alert

Question: On our software, an "etiology" window pops up after I input a V code. I understand why this would be for situations like V58.31 (Encounter for change or removal of surgical wound dressing), but how can we input an etiology code for "Hard of Hearing", "Lives Alone"?

Answer: It sounds as if you may be using too many V codes at the expense of other diagnosis codes and to the detriment of your payment as well as your risk adjustment.

Certain V codes have potential underlying case mix diagnoses, while others don't. For example, the V code for "lives alone" doesn't have an underlying case mix diagnosis. The code for surgical dressing changes, V58.31, sometimes does have an underlying case mix diagnosis; however, if you sequence and use it correctly, the case mix points will be counted elsewhere.

Example: Your patient had surgery for a ruptured appendix. You will be providing aftercare, including dressing changes. Coding for this patientshould be as follows:

In this case, sequence the aftercare code first. The case mix points for the appendicitis have already been captured. The code for the appendicitis is redundant in M0246 and will not capture further points.

Different software is built in different ways. In your case, the software is alerting you anytime any V code appears in M0230 or M0240. Other software vendors built their program to remind the user only if you report certain V codes in M0230 or M0240. As long as the software doesn't stop you from going forward if you don't place a code in M0246, you will be OK.