post op abscess old non functioning dialysis graft
pt had per MD documentation a post op abscess infection of an old non functioning dialysis graft, dx with sepsis , had I&D , culture MRSA.
code for abscess would be T81.40... but post op dialysis graft complications/infection would be T82.7XXA. which would I Code?
also A41.02 is sepsis with MRSA and is usually coded first?
any thoughts?
code for abscess would be T81.40... but post op dialysis graft complications/infection would be T82.7XXA. which would I Code?
also A41.02 is sepsis with MRSA and is usually coded first?
any thoughts?
Comments
-----Original Message-----
From: Tammy Senn [mailto:tammy.senn@alacare.com]
Sent: Wednesday, March 8, 2017 11:50 AM
To: HomeCareCoding-L
Subject: [homecarecoding-l] post op abscess old non functioning dialysis graft
pt had per MD documentation a post op abscess infection of an old non functioning dialysis graft, dx with sepsis , had I&D , culture MRSA.
code for abscess would be T81.40... but post op dialysis graft complications/infection would be T82.7XXA. which would I Code?
also A41.02 is sepsis with MRSA and is usually coded first?
any thoughts?
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.
Confidentiality Notice: This email message and any attachments are confidential and for the sole use of the intended recipient(s). If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email, including any attachments, is prohibited and may be unlawful. If you have received this email in error, please notify the sender by replying to this message and deleting this email, including any attachments, immediately. Please indicate that you were not the intended recipient, and confirm that you have deleted the original message and attachments. Please do not retransmit the contents of the message.
The scenario presented does not really compute. A dialysis "graft" is internal involving artery and venous fistulation so hemodialysis can be done through these specially routed vessels, usually in the forearm, via needle access. The graft would not be NEW for post-op status if it is abandoned. These sites take a very long time to heal internally and are not used until they do heal completely so no puncturing would occur in a post-op timeframe. It would also not be current in-use if home health is seeing the patient for care to the site as that is duplication of benefits. The "old" site to me and the "non-functioning" descriptor tells me this site was used actively for out-patient hemodialysis (I used to set these up as a DC planner case manager) and used to the point of being non-functioning, hence the "old". This is not descriptive of a "post-op" situation. Functional AV grafts do have problems with abscesses forming on the site of needle insertion which occurs 3x's/wk under hemodialysis. Perhaps the physician's documentation needs clarification.
Nancy Wolverton RN, CCM, HCS-D-10
Utilization Review Specialist
Kindred at Home
Little Rock, Arkansas
501-508-8526 (o)
501-690-2027 (c)
Nancy.Wolverton@kindred.com
The scenario presented does not really compute. A dialysis "graft" is internal involving artery and venous fistulation so hemodialysis can be done through these specially routed vessels, usually in the forearm, via needle access. The graft would not be NEW for post-op status if it is abandoned. These sites take a very long time to heal internally and are not used until they do heal completely so no puncturing would occur in a post-op timeframe. It would also not be current in-use if home health is seeing the patient for care to the site as that is duplication of benefits. The "old" site to me and the "non-functioning" descriptor tells me this site was used actively for out-patient hemodialysis (I used to set these up as a DC planner case manager) and used to the point of being non-functioning, hence the "old". This is not descriptive of a "post-op" situation. Functional AV grafts do have problems with abscesses forming on the site of needle insertion which occurs 3x's/wk under hemodialysis. Perhaps the physician's documentation needs clarification.
Nancy Wolverton RN, CCM, HCS-D-10
Utilization Review Specialist
Kindred at Home
Little Rock, Arkansas
501-508-8526 (o)
501-690-2027 (c)
Nancy.Wolverton@kindred.com
-----Original Message-----
From: Perrotta, Marianne [mailto:Marianne.Perrotta@vnahg.org]
Sent: Wednesday, March 08, 2017 12:02 PM
To: HomeCareCoding-L
Subject: [EXTERNAL] RE: [homecarecoding-l] post op abscess old non functioning dialysis graft
T82.7- is more specific so I would go with that. Per instructions for A41.02- code the complication first.
-----Original Message-----
From: Tammy Senn [mailto:tammy.senn@alacare.com]
Sent: Wednesday, March 8, 2017 11:50 AM
To: HomeCareCoding-L
Subject: [homecarecoding-l] post op abscess old non functioning dialysis graft
pt had per MD documentation a post op abscess infection of an old non functioning dialysis graft, dx with sepsis , had I&D , culture MRSA.
code for abscess would be T81.40... but post op dialysis graft complications/infection would be T82.7XXA. which would I Code?
also A41.02 is sepsis with MRSA and is usually coded first?
any thoughts?
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.
Confidentiality Notice: This email message and any attachments are confidential and for the sole use of the intended recipient(s). If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email, including any attachments, is prohibited and may be unlawful. If you have received this email in error, please notify the sender by replying to this message and deleting this email, including any attachments, immediately. Please indicate that you were not the intended recipient, and confirm that you have deleted the original message and attachments. Please do not retransmit the contents of the message.
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.
-----Original Message-----
From: Perrotta, Marianne [mailto:Marianne.Perrotta@vnahg.org]
Sent: Wednesday, March 08, 2017 12:04 PM
To: HomeCareCoding-L
Subject: RE: [homecarecoding-l] post op abscess old non functioning dialysis graft
T82.7- is more specific so I would go with that. Per instructions for A41.02- code the complication first.
-----Original Message-----
From: Tammy Senn [mailto:tammy.senn@alacare.com]
Sent: Wednesday, March 8, 2017 11:50 AM
To: HomeCareCoding-L
Subject: [homecarecoding-l] post op abscess old non functioning dialysis graft
pt had per MD documentation a post op abscess infection of an old non functioning dialysis graft, dx with sepsis , had I&D , culture MRSA.
code for abscess would be T81.40... but post op dialysis graft complications/infection would be T82.7XXA. which would I Code?
also A41.02 is sepsis with MRSA and is usually coded first?
any thoughts?
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.
Confidentiality Notice: This email message and any attachments are confidential and for the sole use of the intended recipient(s). If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email, including any attachments, is prohibited and may be unlawful. If you have received this email in error, please notify the sender by replying to this message and deleting this email, including any attachments, immediately. Please indicate that you were not the intended recipient, and confirm that you have deleted the original message and attachments. Please do not retransmit the contents of the message.
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.
a patient with history of CVA (no more info available) with hemiplegia on the L. side of the body and dysphagia.
I69898
I69952
I69391
Is that a correct sequence? I really appreciate your help.
Thanks,
Nina
-----Original Message-----
From: Brown, Tammy (TRY) [mailto:Tammy.Senn@alacare.com]
Sent: Wednesday, March 8, 2017 10:46 AM
To: HomeCareCoding-L
Subject: RE: [homecarecoding-l] post op abscess old non functioning dialysis graft
Awesome, thanks
-----Original Message-----
From: Perrotta, Marianne [mailto:Marianne.Perrotta@vnahg.org]
Sent: Wednesday, March 08, 2017 12:04 PM
To: HomeCareCoding-L
Subject: RE: [homecarecoding-l] post op abscess old non functioning dialysis graft
T82.7- is more specific so I would go with that. Per instructions for A41.02- code the complication first.
-----Original Message-----
From: Tammy Senn [mailto:tammy.senn@alacare.com]
Sent: Wednesday, March 8, 2017 11:50 AM
To: HomeCareCoding-L
Subject: [homecarecoding-l] post op abscess old non functioning dialysis graft
pt had per MD documentation a post op abscess infection of an old non functioning dialysis graft, dx with sepsis , had I&D , culture MRSA.
code for abscess would be T81.40... but post op dialysis graft complications/infection would be T82.7XXA. which would I Code?
also A41.02 is sepsis with MRSA and is usually coded first?
any thoughts?
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.
Confidentiality Notice: This email message and any attachments are confidential and for the sole use of the intended recipient(s). If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email, including any attachments, is prohibited and may be unlawful. If you have received this email in error, please notify the sender by replying to this message and deleting this email, including any attachments, immediately. Please indicate that you were not the intended recipient, and confirm that you have deleted the original message and attachments. Please do not retransmit the contents of the message.
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.
Do you have a Decision Health book? It would help alot. There are coding tips, etc. that are helpful for homecare and hospice.
Do you have a Decision Health book? It would help alot. There are coding tips, etc. that are helpful for homecare and hospice.
Sent via the Samsung Galaxy S® 6, an AT&T 4G LTE smartphone
-------- Original message --------From: Nina Jalali Date: 3/8/17 5:38 PM (GMT-05:00) To: HomeCareCoding-L Subject: RE: [homecarecoding-l] post op abscess old non functioning dialysis graft
Hi everyone,
a patient with history of CVA (no more info available) with hemiplegia on the L. side of the body and dysphagia.
I69898
I69952
I69391
Is that a correct sequence? I really appreciate your help.
Thanks,
Nina
-----Original Message-----
From: Brown, Tammy (TRY) [mailto:Tammy.Senn@alacare.com]
Sent: Wednesday, March 8, 2017 10:46 AM
To: HomeCareCoding-L
Subject: RE: [homecarecoding-l] post op abscess old non functioning dialysis graft
Awesome, thanks
-----Original Message-----
From: Perrotta, Marianne [mailto:Marianne.Perrotta@vnahg.org]
Sent: Wednesday, March 08, 2017 12:04 PM
To: HomeCareCoding-L
Subject: RE: [homecarecoding-l] post op abscess old non functioning dialysis graft
T82.7- is more specific so I would go with that. Per instructions for A41.02- code the complication first.
-----Original Message-----
From: Tammy Senn [mailto:tammy.senn@alacare.com]
Sent: Wednesday, March 8, 2017 11:50 AM
To: HomeCareCoding-L
Subject: [homecarecoding-l] post op abscess old non functioning dialysis graft
pt had per MD documentation a post op abscess infection of an old non functioning dialysis graft, dx with sepsis , had I&D , culture MRSA.
code for abscess would be T81.40... but post op dialysis graft complications/infection would be T82.7XXA. which would I Code?
also A41.02 is sepsis with MRSA and is usually coded first?
any thoughts?
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.
Confidentiality Notice: This email message and any attachments are confidential and for the sole use of the intended recipient(s). If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email, including any attachments, is prohibited and may be unlawful. If you have received this email in error, please notify the sender by replying to this message and deleting this email, including any attachments, immediately. Please indicate that you were not the intended recipient, and confirm that you have deleted the original message and attachments. Please do not retransmit the contents of the message.
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.
From: tkrol [mailto:tkrol@Hometownhhh.com]
Sent: Wednesday, March 8, 2017 3:46 PM
To: HomeCareCoding-L
Subject: RE: [homecarecoding-l] post op abscess old non functioning dialysis graft
I69.354 (Unless otherwise specified use left non-dominant side)
I69.391 Dysphagia following CVA
R13.10 -must be added as well
Do you have a Decision Health book? It would help alot. There are coding tips, etc. that are helpful for homecare and hospice.
Sent via the Samsung Galaxy S® 6, an AT&T 4G LTE smartphone
-------- Original message --------
From: Nina Jalali
Date: 3/8/17 5:38 PM (GMT-05:00)
To: HomeCareCoding-L
Subject: RE: [homecarecoding-l] post op abscess old non functioning dialysis graft
Hi everyone,
a patient with history of CVA (no more info available) with hemiplegia on the L. side of the body and dysphagia.
I69898
I69952
I69391
Is that a correct sequence? I really appreciate your help.
Thanks,
Nina
-----Original Message-----
From: Brown, Tammy (TRY) [mailto:Tammy.Senn@alacare.com]
Sent: Wednesday, March 8, 2017 10:46 AM
To: HomeCareCoding-L
Subject: RE: [homecarecoding-l] post op abscess old non functioning dialysis graft
Awesome, thanks
-----Original Message-----
From: Perrotta, Marianne [mailto:Marianne.Perrotta@vnahg.org]
Sent: Wednesday, March 08, 2017 12:04 PM
To: HomeCareCoding-L
Subject: RE: [homecarecoding-l] post op abscess old non functioning dialysis graft
T82.7- is more specific so I would go with that. Per instructions for A41.02- code the complication first.
-----Original Message-----
From: Tammy Senn [mailto:tammy.senn@alacare.com]
Sent: Wednesday, March 8, 2017 11:50 AM
To: HomeCareCoding-L
Subject: [homecarecoding-l] post op abscess old non functioning dialysis graft
pt had per MD documentation a post op abscess infection of an old non functioning dialysis graft, dx with sepsis , had I&D , culture MRSA.
code for abscess would be T81.40... but post op dialysis graft complications/infection would be T82.7XXA. which would I Code?
also A41.02 is sepsis with MRSA and is usually coded first?
any thoughts?
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.
Confidentiality Notice: This email message and any attachments are confidential and for the sole use of the intended recipient(s). If the reader of this email is not the intended recipient or his or her authorized agent, the reader is hereby notified that any dissemination, distribution, or copying of this email, including any attachments, is prohibited and may be unlawful. If you have received this email in error, please notify the sender by replying to this message and deleting this email, including any attachments, immediately. Please indicate that you were not the intended recipient, and confirm that you have deleted the original message and attachments. Please do not retransmit the contents of the message.
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.
---
This list is a co-sponsored service of the Board of Medical Specialty Coding & Compliance (http://www.medicalspecialtycoding.com) and DecisionHealth (http://www.decisionhealth.com), publisher of Diagnosis Coding Pro for Home Health. To access the web interface, go to http://www.decisionhealth.com/homecarecoding-l and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages.