biliary drain

jcrimmins@stoughton-ma.govjcrimmins@stoughton-ma.gov
in Home Care Coding General
pt has biliary drain..we are flushing and changing dressing. Pt has intrahepatic abscess / cholecystitis with gallbladder perforation...(going in for surg in 2 days for removal of gallbladder)!! finished Iv antibiotics at rehab...only po at this time...please help with codes...thank you

Comments

  • Nancy.Wolverton@kindred.comNancy.Wolverton@kindred.com
    edited April 2017
    Code the intrahepatic abscess K75.0 first, followed by the (complex) cholecystitis code (rupture) K82.2 with K81.0 (rupture not clarified as having been surgically or otherwise repaired), followed by Z46.82 Enct for fitting and adjustment of non-vascular catheter.
    I did use Z48.03 but a recent Coding Pro article on this subject has clarified that Z48.03 is used ONLY IF HH IS CHANGING OUT OR REMOVING THE DRAIN ITSELF. NOT TO BE USED FOR ROUTINE DRAIN CARE. That care is included with use of Z48.8- codes (AC post-procedural codes).

    Nancy Wolverton RN,CCM, HCS-D
    QR Specialist, Central Office
    5800 West 10th St., Suite 300
    Little Rock, AR. 72205
    Ph# 501-280-4913
    Fax# 501-280-4385
    Nancy.Wolverton@arkansas.gov
  • elstewartelstewart
    I'm coding a similar situation, was wondering if you would have input (you seem experienced with this) :)

    If the patient has...
    K80.45 - calculus of bile duct, chronic cholecystitis with obstruction
    Had a biliary drain inserted (Z46.82)
    & nurse is changing dressings at the tube site - does this mean I need to code the (Z48.815)aftercare for digestive system as well?
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