Home Health ICD-9/ICD-10 Alert

Question: Your new codes story in the last issue included the new 996.4x series of codes for mechanical complication of internal orthopedic device, implant, and graft. Aren't these codes more suited to acute care situations, with home care using the same after care codes that we always have? In what situations might we actually use these new codes?

Arizona Subscriber

Answer: You are right. The most common use of these codes will likely be in M0190 or M0210 to report the inpatient diagnosis or diagnosis requiring change. Although you may care for the patient prior to a revision, in which case the code would be 996.4x (Mechanical complication of internal orthopedic device, implant, and graft), you will most likely code V54.81 (Aftercare following joint replacement) for aftercare of the joint replacement once there has been a revision--assuming that there are no further complications. Note that both 996.4x and V54.81 require V43.6x (Organ or tissue replaced by other means, joint) to indicate the affected joint.