Home Health ICD-9/ICD-10 Alert
Watch For Coverage Issues With Dialysis
Question: A patient just had an AV shunt placed for renal dialysis. She has been on dialysis for some time now. The nurse will be observing the site for any signs of infection. The patient is cleansing and covering the site. New York Subscriber
Is there an aftercare code for the creation of an AV shunt? I was thinking of V58.76 (Aftercare following surgery of the genitourinary system, NEC) and V45.1 (Renal dialysis status), but I don't know if these codes are correct.
Answer: If the patient underwent surgery to place the shunt for renal dialysis, you could code for care to the AV shunt placement with V58.76. This is the correct aftercare code for conditions classifiable to 580-629, and you'll find the renal codes in the 580-589 categories.
However, you have a potential coverage problem here. If the patient is a Medicare patient and is receiving dialysis through the shunt, homecare cannot take care of the shunt. This care would be considered duplication of services. Medicare guidelines state that home health can only care for a dialysis site if it has been abandoned.
Home Health ICD-9/ICD-10 Alert
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