ICD 10 Coding Alert
Aftercare Code Supports Post-Bypass Scan
Question: Which diagnosis code should I report when a patient has had bypass surgery and comes in for a follow-up lower extremity duplex scan?
Iowa Subscriber
Answer: Right now, you should use V58.49 (Other specified aftercare following surgery) with 93926 (Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study) according to Iowa’s Part B MAC, Wisconsin Physician Service (LCD L28586, searchable at www.cms.gov/medicare-coverage-database/overview-and-quick-search.aspx).
A note in ICD-9 with V58.49 states the code “should be used in conjunction with other aftercare codes to fully identify the reason for the aftercare encounter.
Because the patient has had a lower extremity bypass, you may add V45.89 (Other postsurgical status).
ICD-10: When your diagnosis system changes, you’ll have to report Z48.03 (Encounter for change or removal of drains) or Z48.89 (Encounter for other specified surgical aftercare). As for V45.89, you should examine your documentation, but you will most likely look at the equivalent of Z98.89 (Other specified postprocedural states).
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