Lesion After Starting Radiation-Venous Ulcer-Chronic Venous Hypertension W Ulcer?

kbeau78@gmail.comkbeau78@gmail.com
in Home Care Coding General
Patient admitted for Acute renal failure. Had wound care in hospital for a chronic wound to leg. Wound clinic states lesion started after radiation a year ago and was coded as S81.802A. Biopsy month ago states venous ulcer. Nurses coded as chronic venous hypertension I87.313 with ulcer. Patient does have hypertension but there is no mention of the wound (in fact H&P, prog notes do not mention the wound at all) as I87.313. Is this a given correlation? NANCY? Thanks!

Comments

  • MperrottaMperrotta
    edited May 2017
    Is venous stasis or insufficiency in md doc?
  • kbeau78@gmail.comkbeau78@gmail.com
    On SOC--RN stated:#1 is 1.0 cm x 1.6 cm #2 is 2.1 cm x 1.8 cm #3 is 2.1 cm x 1.9 cm wounds are from the fluid overload to the ble r/t liver cancer/cirrhosis and ascites. F2F does not state wound care. On last inpatient admit for this ROC for"ascites", in the ROS, MD stated 3+ edema legs and feet, peripheral pulses diminished but no diagnosis. There is no specific orders for the ROC of care other than to continue HH. No diagnosis for venous insuffiency. Patient also is obese. Thanks for helping me understand what the wounds actual are!
  • MperrottaMperrotta
    edited May 2017
    I think the clinician needs to confirm wound dx with MD since MD did not doc wounds.
  • kbeau78@gmail.comkbeau78@gmail.com
    Thanks, I agree but this will not happen. I will make my notes and attach to my coding. Have a great day!
  • kerry.armogida@ashealthnet.comkerry.armogida@ashealthnet.com
    edited May 2017
    Need to query and clarify with MD as to type of wounds




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