AV fistula placed due to ESRD

JRPATJRPAT
in Home Care Coding General
Would I code primary code as Z48.816 (A/C following surgery for genitourinary system)?

Comments

  • Nancy.Wolverton@kindred.comNancy.Wolverton@kindred.com
    edited May 2017
    If this is a Medicare event, you cannot do aftercare on a dialysis-related access even if it is not yet accessed.
    That is a duplication of services under Medicare benefits. Can only do abandoned site care.

    Nancy Wolverton RN,CCM
    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
  • JRPATJRPAT
    I've never heard of an abandoned site care code. Do you know what it is, off hand?
  • Nancy.Wolverton@kindred.comNancy.Wolverton@kindred.com
    edited May 2017
    Abandoned means the AV fistula has been "abandoned" by dialysis and will never be used again for dialysis.
    Same for the PD catheter. If the site is no longer usable and requires "site care" for say, an open infection at the site, then the PD site is an abandoned site and therefore no longer covered by the patient's dialysis (ESRD) benefits under Medicare, so regular HH can care for the site now.
    Only Dialysis nurses can care for a site that is to be used or is in use. Not HH.
    See Medicare Benefits Manual under ESRD benefits and under HH regarding ESRD care.
    CMS.gov

    Nancy Wolverton RN,CCM
    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
  • Nancy.Wolverton@kindred.comNancy.Wolverton@kindred.com
    edited May 2017
    There is no abandoned site care code.

    Nancy Wolverton RN,CCM
    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
  • JRPATJRPAT
    Ok, thanks for the help Nancy.
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