Posts tagged ‘v58.73’

January 4, 2011

V58.73 is the code for cardiac catheterization with a stent

How do you code a cardiac catheterization with a stent? Aftercare? V55?

A cardiac catheterization is not considered an ostomy, so do not use V55 codes. V55 codes are not used for temporary ostomies. i.e., openings, because V55 deals with permanent placements. Use V58.73 for aftercare of the circulatory surgery. A cardiac catheterization by cut down is considered a surgical wound so mark the surgical wound questions (M1340 and M1342) appropriately for status of healing on the OASIS. A cardiac catheterization by needle puncture is not a surgical wound so make sure to mark M1350 as yes. M1350 deals with a skin lesion or open wound that excludes ostomy or other wounds addressed in the M1300s of OASIS.

The instructions at M1350 state: Ostomies, other than bowel ostomies, (e.g., tracheostomy, thoracostomy, urostomy) ARE considered to be skin lesions or open wounds if clinical interventions (e.g., cleansing, dressing changes) are being provided by the home health agency during the home health care episode.

The other items that would be excluded from M1350: Pressure Ulcers or risk of pressure ulcers (M1300, M1302, M1306, M1307. M1308, M1310, M1312, M1314, M1320, M1322, M1324), stasis ulcers (M1330, M1332, M1334), surgical wounds (M1340, M1342).

January 4, 2011

Code ostomy takedowns by disease

An ostomy takedown, where the stoma and skin opening are closed, should be coded by the original reason for the ostomy.

If the patient had colon cancer and needed a colostomy, code V58.42 for aftercare of surgery. Code the colon cancer as appropriate for an active disease or M1024 if no longer active. If the patient had a bowel obstruction or diverticulitis that resulted in the ostomy, V58.73 would be coded for aftercare. The bowel obstruction is mostly resolved so would be coded in M1024, not M1022. Diverticulitis could be resolved or still active so the choice of coding the condition in M1022 depends on whether the condition is resolved or not.

With the takedown, the opening is no longer there, so V55.3 is not a valid code. V55 codes deal with permanent ostomies!

Remember with an aftercare of surgery code that the dressing change is not part of the aftercare, so if a dressing change is part of your care,  also code V58.3x, wound dressing codes.

August 5, 2010

When are PT/INRs considered skilled care?

There is a lot of confusion over skilled care when it comes to venipuncture ….

Venipuncture is considered a skill, just not a qualifying skill. Most likely you are performing observation and assessment of the condition that requires an anticoagulant. If performing the PT/INR by one of the machines, it is still a skill.

To code correctly, code the condition, then V58.83 (Encounter for therapeutic monitoring of medications), and V58.61 (Long term use of anticoagulants).