Wiki Please help with DX Code....

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landv

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My physician performed a colostomy with hartman prior to a plastic surgeon's planned flap procedure for Grade 4 decubitus ulcer on buttocks. The plastic surgeon wanted the procedure performed to divert the cecal stream and assist in wound healing after the flap procedure. I am having difficulty finding the appropriate ICD9 code. I have the codes for the ulcer but I'm not sure what other codes are appropriate. The pathology from the colostomy doesn't indicate any abnormality.The payor is Medicare. Please help.... Thank you.
 
you may just have to use a V-code for other specified prophylactic or treatment measures (V07.8) I don't know how Medicare will respond to this code but use it as secondary to the ulcer code.
 
The surgical procedure is common practice for this type of ulcer. Therefore, you should not need any other dx codes to support the procedure as it supports it medical necessity. I have never had a denial from Medicare for filing a claim with only the stage IV decubitus ulcer dx code.

-Judy Haroon, RN, BSN, CPC, CGSC
 
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