Nickiemay15
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Fellow Coders,
I work in a skilled nursing facility with a small number of long-term care beds. We have a few Hospice patients. I know coding here is very different from most inpatient and outpatient facilities, but I find that the specific regulations surrounding coding are hard to find. Even here on AAPC, there isn't a forum for this specified type of facility. Is there anyone that is a specialist in this type of faciliy? I have a hard time coding the aftercare versus acute codes in this facility.
For example:
A patient comes in s/p a surgery to remove a neoplasm (regardless of body system...let's just say brain)
Now, after this is where I get foggy. My MDS girls insist I need to code the mal. neoplasm...but it's been cut out...no mets or other remaining cells...so shouldn't I code it as historical?
Another example:
A patient comes in s/p a surgery to replace a joint (again, doesn't matter which, we'll just say knee) due to osteoarthritis
Do I code the OA for that joint, even though s/p the replacement there is no OA in that joint??
And this list goes on and on:
Abdominal abscess s/p removal
CAD s/p CABG
Joint infection s/p I&D
What about strokes? When they have a CVA, the sources I've found all say that you don't code late effects until after 2 weeks, otherwise they're expected side effects you don't code. But my girls insist they need these codes...what do I do for this??
I obviously have a lot of LTC coding questions. If I could find someone that is able to answer a few questions and guide me, I'd really appreciate it.
I work in a skilled nursing facility with a small number of long-term care beds. We have a few Hospice patients. I know coding here is very different from most inpatient and outpatient facilities, but I find that the specific regulations surrounding coding are hard to find. Even here on AAPC, there isn't a forum for this specified type of facility. Is there anyone that is a specialist in this type of faciliy? I have a hard time coding the aftercare versus acute codes in this facility.
For example:
A patient comes in s/p a surgery to remove a neoplasm (regardless of body system...let's just say brain)
- Code the aftercare of the surgery
- Code the surgical dressings
- Irraddiation/Chemo
Now, after this is where I get foggy. My MDS girls insist I need to code the mal. neoplasm...but it's been cut out...no mets or other remaining cells...so shouldn't I code it as historical?
Another example:
A patient comes in s/p a surgery to replace a joint (again, doesn't matter which, we'll just say knee) due to osteoarthritis
- Code the aftercare of the surgery (joint replacement)
- Code the joint replacement itself
- Code the surgical dressing
- Code the therapy
Do I code the OA for that joint, even though s/p the replacement there is no OA in that joint??
And this list goes on and on:
Abdominal abscess s/p removal
CAD s/p CABG
Joint infection s/p I&D
What about strokes? When they have a CVA, the sources I've found all say that you don't code late effects until after 2 weeks, otherwise they're expected side effects you don't code. But my girls insist they need these codes...what do I do for this??
I obviously have a lot of LTC coding questions. If I could find someone that is able to answer a few questions and guide me, I'd really appreciate it.