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Wiki post op x-rays

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MarciaH

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I have run into a dilemma coding post-op x-rays so if anyone could help me, I'd greatly appreciate it. My office manager tells me to use 71907 as this has been paid in the past. I know this is wrong! You don't code what's not in the chart notes.

If the patient isn't having any pain or swelling after surgery (say a bunionectomy) and doctor does an x-ray to check on placement, what would you code? Can I code a fracture code since it's a surgical fracture? Or do I code a bunion (7271)? Or do I use a V code for "aftercare"? Has anyone had any experience with "aftercare" codes? Do they get paid?

Thanks in advance!
 
MarciaH said:
I have run into a dilemma coding post-op x-rays so if anyone could help me, I'd greatly appreciate it. My office manager tells me to use 71907 as this has been paid in the past. I know this is wrong! You don't code what's not in the chart notes.

If the patient isn't having any pain or swelling after surgery (say a bunionectomy) and doctor does an x-ray to check on placement, what would you code? Can I code a fracture code since it's a surgical fracture? Or do I code a bunion (7271)? Or do I use a V code for "aftercare"? Has anyone had any experience with "aftercare" codes? Do they get paid?

Thanks in advance!
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Since you stated the patient isn't having any pain/swelling...x-ray is performed to check placement/alignment, aftercare is often used for these scenarios. The documentation should support an aftercare diagnosis.

Aftercare
Aftercare visit codes cover situations when the initial treatment of a disease or injury has been performed and the patient requires continued care during the healing or recovery phase, or for the long-term consequences of the
disease.

Follow-up
The follow-up codes are used to explain continuing surveillance following completed treatment of a disease, condition, or injury. They imply that the condition has been fully treated and no longer exists. They should not be confused with aftercare codes that explain current treatment for a healing condition or its sequelae. Follow-up codes may be used in conjunction with history codes to provide the full picture of the healed condition and its treatment. The follow-up code is sequenced first, followed by the history code. A follow-up code may be used to explain repeated visits. Should a condition be found to have recurred on the follow-up visit, then the diagnosis code should be used in place of the follow-up code.
The follow-up V code categories:
V24 Postpartum care and evaluation
V67 Follow-up examination

http://www.shopingenix.com/content/updates/ICD9/ICD-9-CM_Official.pdf

Pages 26-27
 
I've run into the fact that most insurances do not like v codes as primary dx codes on xrays. I would bill what the patient had surgery for i.e. bunion and the the v code for the aftercare.
 
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