CVA, V12.54 and Hemiplegia

There seem to be some lingering questions from guidance of a few months ago. This issue is one that never seems to  go away: CVA.In the past, the Coding Clinic had instructed hospitals not to code hemiplegia in acute CVA patients if the hemiplegia had resolved before discharge. (Q2, 1989) A question in the Q2 2009 Coding Clinic asked for reconsideration of this policy, given the significance of the diagnosis and the fact that many patients may be receiving therapy, even though the diagnosis is resolved.

This should not affect home health coding, given we cannot use acute codes in M1020 or M1022. We use late effects. Three codes deal with hemiplegia …

438.20, Hemiplegia affecting unspecified side
438.21, Hemiplegia affecting dominant side
438.22, Hemiplegia affecting nondominant side
We should be able to continue to code these for our therapy patients.

This change should not affect V12.54, history of TIA/CVA. Since all the deficits are resolved before our patients get to us, there are no late effects to deal with. We can still code acute stroke in M1010 and M1016 provided within 14 days.

One Comment to “CVA, V12.54 and Hemiplegia”

  1. in M1010- IP diagnosis (hospital discharge only), in a patient w/ new cva and new onset hemiparesis do we use 434 and 342 code or 434 and 438 code?

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