Home Health ICD-9/ICD-10 Alert

Question: Our patient has an implanted port infected with Staphylococcus aureus resistant to penicillin and bacitracin. She also has MRSA pneumonia. Our focus of care is wound care for the port. How should we code for her?

-- New Jersey Subscriber.

Answer: List the following codes for this patient, says Judy Adams, RN, BSN, HCS-D, COS-C, president and CEO of Adams Home Care Consulting in Chapel Hill, N.C.

• M0230a: 999.31 (Infection due to central venous catheter);

• M0240b: 041.12 (Methicillin resistant Staphlococcus aureus);

• M0240c: V09.81 (Infection with microorganisms resistant to multiple drugs, with resistance to multiple drugs); and

• M0240d: 482.42 (Methicillin resistant pneumonia due to Staphlococcus aureus).

You're providing wound care for this patient, but the wound is complicated, so it's not appropriate to use a V code for wound care or aftercare. Instead, list 999.31 to describe the infected wound. Next, coding guidelines require you to list a code to identify the specified infection -- 041.12 in this case. Use V09.81 to show that the infection is resistant to multiple drugs. Finally, 482.42 adds specificity by indicating that the patient's pneumonia was caused by MRSAresistant Staphlococcus aureus.