Home Health ICD-9/ICD-10 Alert

Question: Your patient is admitted following hospital treatment for malignant essential hypertension, pneumonia (E.coli) and acute respiratory failure. Orders are for PT and nursing. The therapist will be making more than 10 visits and addressing muscle weakness with an exercise program and balance and transfer training. Nursing frequencies are 4M1, 2M1. The RN will be seeing the patient for blood draws and medication monitoring, observation and assessment, and teaching. How would you code this episode?

Answer: PT would be primary, because the therapist is providing the most intensive services, assuming the record supports weakness as the most acute problem, says Laresa Boyle, director of coding services at Longview, TX-based Healthcarefirst. These codes assume the antibiotics are for continuing treatment of the pneumonia. Code the episode as follows, she says:

M0230 - V57.1 (Other physical therapy)

M0240 - 728.87 (Muscle weakness)

           - 401.0 (Essential hypertension, malignant)

           - 518.81 (Acute respiratory failure)

           - 482.82 (Pneumonia due to other specified bacteria, E.coli)  
  
Tip: If the patient no longer has the acute respiratory failure, you would not need to code this condition, coding consultant Lisa Selman-Holman reminds coders.