2011 Guidelines Clarify V07, ‘With’ and some CVA

2011 Coding Guidelines have been updated, and there are very few additions to the Guidelines. I am still scanning for any deletions (which are not noted by CMS). Here, first, are some additions to watch:

In the Conventions section, there is a clarification of “with” when used in the Tabular List and Index. With “should be interpreted to mean ‘associated with’ or
‘due to.'”

There are two notes at CVA. Neither applies to home health, but I’ll write about them because CVA is such a watched (and miscoded) diagnosis.

One note at CVA talks about coding neurologic deficits regardless of whether they resolve prior to discharge. Remember that this applies to acute discharge, not home health.

The second note states that 438 codes are for late effects of cerebrovascular disease (which we know, because we use this code category, note 434), not for neurologic deficits associated with an acute CVA. This simply confirms that 438 codes are for post-acute settings, such as home health. There are no code change implications for home health, and this guidance goes along with 3rd Quarter 2009 Coding Clinic guidance where even resolved deficits are code in acute settings, even if resolved at discharge.

V codes always have changes, and there is a general clarification of what Status codes are, with new guidelines stating that these are …. codes that show a patient is a carrier of a disease, has the sequelae or residual or has another factor influencing health.

Following the changes to the Tabular List, the guidelines now indicate that V07 is appropriate for prophylactic or treatment measures.

Those are the main additions … I’ll post more if there are other changes or deletions I find out about.

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