Home Health ICD-9/ICD-10 Alert

Question: We are caring for a 60-year-old woman with Type II diabetes who had an above-knee amputation two months ago. The amputation was necessary due to peripheral angiopathy in the limb caused by her diabetes. We will be providing care for an abscess of the stump that developed following surgery. How should we code for her?

-- Utah Subscriber.

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

• M1020a: 997.62 (Amputation stump complication; infection [chronic]);

• M1022b: 682.6 (Other cellulitis and abscess; leg, except foot);

• M1022c: 250.70 (Diabetes with peripheral circulatory disorders; type II or unspecified type, not stated as uncontrolled); and

• M1022d: 443.81 (Peripheral angiopathy in diseases classified elsewhere).

You're caring for this patient following an amputation, but it's not appropriate to list a V code for aftercare because there is a complication present. You also shouldn't list an amputation status V code for the same reason.

Your primary focus of care is the complication of the amputation stump, coded with 997.62. Follow this with 682.6 to specify the abscess.

The patient's diabetes and resultant circulatory problem was the cause of the amputation, so you'll list 250.70 next, followed by 443.81 to indicate the circulatory manifestation.