Home Health ICD-9/ICD-10 Alert

Question: Our patient was admitted for aftercare following surgery to remove an infection surrounding a knee prosthesis inserted two weeks ago. She is receiving Vancomycin for MRSA (Methicillin resistant staph aureus). How should we code for her?

New Mexico Subscriber

Answer: List the following codes for this patient, says Conetoe, N.C.-based coding and billing specialist Vonnie Blevins, HCS-D:

• M0230a: 996.66 (Infection and inflammatory reaction due to internal joint prosthesis);

• M0240b: 041.12 (Methicillin resistant Staphylococcus aureus);

• M0240c: V43.65 (Organ or tissue replaced by other means; joint; knee);

• M0240d: V58.81 (Fitting and adjustment of vascular catheter, NEC); and

• M0240e: V58.62 (Long-term [current] use of antibiotics).

The prosthetic joint is causing the infection so code your primary diagnosis as 996.66. Follow this by the infective organism (MRSA) and then the joint that is infected (V43.65 for the knee), Blevins says. Then, list V58.81 for fitting and adjustment of a vascular catheter.

If only the incision was infected rather than the knee prosthesis you would list:

• M0230a: 998.59 (Other postoperative infection) and

• M0240b: 041.12.

Tip: If you will be drawing labs for the peak and trough add V58.83 (Encounter for therapeutic drug monitoring) before the V58.62, Blevins says.