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Home Health ICD-9/ICD-10 Alert

You Be The Coder:

Which Diagnoses Affect Care?

Published on Thu Sep 02, 2004

Question: Your newest home care patient just returned from the hospital after coronary artery bypass surgery, following years of hypertension. Nursing is the primary discipline for this episode and will provide aftercare such as watching for infection of the incisions and peripheral edema, teaching the patient about diet and activity and monitoring pain. The patient also has early Alzheimer's, but has no behavioral problems and manages with his wife's help. How would you code this case?

Answer: You should code the following:

  •  M0230 - V58.73 (Aftercare following surgery of the circulatory system).

  •  M0240 - 414.00 (Coronary artery disease), 401.9 (Hypertension), 331.0 (Alzheimer's disease).

    Be sure to get more information. If the care includes dressing changes and suture care, V58.3 (Attention to surgical dressings and sutures) would be an additional M0240 diagnosis. If there are labs for monitoring Coumadin therapy, you would also need V58.61 (Long term [current] use of anticoagulants) or V58.83 (Encounter for therapeutic drug monitoring) in addition to the specific V code for anticoagulants (see Reader Question: Eliminate Coagulation Confusion). If the procedure was secondary to something other than coronary artery disease, that should be coded instead, explains Cushing, OK-based home health coding consultant Laresa Boyle. If you have more specific information about the hypertension, you would code that in the fourth and fifth digits. The Alzheimer's is included because it will have an impact on his care, Boyle adds.

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