Posts tagged ‘abnormality of gait’

September 7, 2012

Use official guidance to help with symptom coding

Symptom coding is always confusing!

Should I code abnormality of gait for example if my patient has hemiplegia? What about if she’s falling and the physician doesn’t have an explanation for the falls yet?

If you have the DecisionHealth 2012 Complete Home Health ICD-9-CM Diagnosis Coding Manual turn to p. 1039 and read the second paragraph. Some of those examples do not apply to home care but it is a good summary of when we do use symptom codes. The part about integral or not is in the general coding guidelines p.29 #6-8. That should help you think about whether you need abnormality of gait, difficulty walking or any other symptom!!

By the way, those symptom codes are not required just because you’re adding therapy to the mix. There is no separate set of rules when it comes to coding for therapy in home care!

If you don’t have that particular coding manual, it’s still in your book, because it’s official guidance! For other manuals, look at the first page of Chapter 16 (780-799) and the Official Guidelines for Coding and Reporting, Section I.B.6-8.

August 24, 2010

Confusion over case mix and 781.2? No.

Question: People were overusing 781.2, and then the criteria changed on how to capture case mix points: You also needed and ulcer and/or IV therapy. Is this still the criteria?

Lisa says: The criteria haven’t changed since January 2008.  Abnormality of gait is still case mix, but does not receive points unless the patient also has a pressure ulcer, it’s an early episode and there are less than 14 therapy visits. (See row 19 of CMS’s Table 4 for the official cite.)

Infusion therapy has never been part of the criteria for 781.2. Always remember that you code for medical necessity and services provided, NOT case mix.