Home Health ICD-9/ICD-10 Alert

Question: Our new patient is a 72 year-old lady referred to home health following hospitalization for influenza with Staph aureus pneumonia, and exacerbation of her COPD. She is to receive IV antibiotics at home and is on continuous oxygen. How should we code for her?

Louisiana Subscriber

Answer: Code for this patient as follows, says Andrea Manning, BS, RN, HCS-D, COS-C, of Manning Healthcare Group in Talkeetna, AK.:

·         M1020a: 487.0 (Influenza caused by unspecified influenza virus ;with pneumonia);

·         M1022b: 482.41 (Pneumonia due to Staphylococcus aureus NOS) ;

·         M1022c: 491.21 (Obstructive chronic bronchitis with [acute] exacerbation) ;

·         M1022d: V58.81 (Fitting and adjustment of vascular catheter) ;

·         M1022e: V58.62 (Long-term [current] use of antibiotics); and

·         M1022f: V46.2 (Long-term oxygen therapy).

Your patient has influenza with pneumonia, so you’ll list 487.0 as your principal diagnosis along with an additional code to identify the type of pneumonia. Your pneumonia code, 482.41, includes the organism, so there’s no need to list another additional code to indicate the organism.

Your patient experienced an acute exacerbation of her COPD, so you should use the more specific COPD code 491.21. Remember not to use 496 (Chronic airway obstruction, not elsewhere classified) with any code from categories 491-493 because these codes are all specific forms of COPD.  

Also include V codes to indicate care of the IV catheter, long term use of antibiotics, and long term use of oxygen, sequencing them at the bottom of your list.