need help coding---neuro

pt had burr hole surg for right subdural hematoma...returned 3 days later to hosp for more drainage of hematoma..returned 1 day later with seizures and left sided weakness...(this was all in the course of 7 days with rehospitalization).....then we got him at home for a homecare admit....help with coding...Is it aftercare neuro surgery? There is after effects..please help

Comments

  • Is there sequelae? Pt suffered the SDH s/p fall on 9/14 ...had burr hole done 10/7 repeat done 10/11...readmitted 10/15 with the left arm weakness and seizures...then we got him from that discharge
  • I think you need to look at how/why the subdural hematoma developed in the
    first place.

    Arlene Poolman, RN
    Director of Clinical Services
    At Home Rehab
    800.880.9715

    The Professional Care YOU Deserve
  • it was a result of a fall....so it was traumatic....but the seizures and
    weakness were after the burr hole surgery for the drainage of the
    hematoma...Do I capture these even though resolved? Do I just code
    aftercare? I guess im stumped on this one
  • Hi Janet.
    The Subdural Hematoma caused by the fall; i.e.: traumatic head injury, is the primary diagnosis. The Burr Holes are the treatment done to relieve the pressure caused by the bleeding from the hematoma. The hematoma and the fall injury did cause damage: the seizures and now the weakness, and maybe more to come as SDH have sequel that can come forth in the near or distant future.
    Code the injury as primary, and then code all the symptoms and conditions that have appeared as a result of the injury.
    If you have orders for care of the surgical site on the head, then code att’n to surgical dressing. I would not code AC neuro surgery as this is not the focus of your POC. The focus is the injury recovery in my humble opinion.

    Nancy Wolverton RN, CCM, HCS-D
    Kindred at Home
    Little Rock, Arkansas
    501-508-8526
    Nancy.Wolverton@kindred.com
  • Nancy I think I speak from everyone when I say thank you for doing such a
    good job in explaining things J



    Arlene Poolman, RN

    Director of Clinical Services

    At Home Rehab

    800.880.9715



    *The Professional Care YOU Deserve*
  • I learn things from you too Arlene! And several others as well.
    That is how this site works! Ain’t it grand!

    Nancy Wolverton RN, CCM, HCS-D
    Kindred at Home
    Little Rock, Arkansas
    501-508-8526
    Nancy.Wolverton@kindred.com
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