aftercare code

jill.sanborn@midmichigan.orgjill.sanborn@midmichigan.org
in Home Care Coding General
I'm looking at a chart and the patient had a bka due to critical limb ischemia. I think the aftercare for surgical amputation is appropriate but one of our nurses thinks it should be the aftercare code for the circulatory system. I do see her point, what do you think?

Comments

  • Nancy.Wolverton@kindred.comNancy.Wolverton@kindred.com
    edited April 2017
    The critical limb ischemia is no longer the case. It was eliminated by the amputation, therefore the AC is not for the circulatory system, it is for surgical amputation AC.
    The amputation relieved the ischemia and is no longer present. The amputation did and that is what HH is now focused on.
    HH cannot address the circulatory system AC because the fix for the patient's problem is surgery involving the amputation.
    This captures the most correct POC and focus now. There was no circulatory system surgery performed per coding guidelines.
    You must use the amputation AC. You win the argument.

    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 April 2017
    The craniotomy is the surgical approach. The reason for the approach is the perform a procedure on a vessel, so your answer is yes.

    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
  • Nancy.Wolverton@kindred.comNancy.Wolverton@kindred.com
    The craniotomy is the surgical approach. The reason for the approach is the perform a procedure on a vessel, so your answer is yes.

    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: Reyhan Rzayeva [mailto:reyhan@nyshh.com]
    Sent: Thursday, March 09, 2017 12:46 PM
    To: HomeCareCoding-L
    Subject: [EXTERNAL] [homecarecoding-l] aftercare code

    Would you code "aftercare following surgery for circulatory system" for craniotomy done for the purpose of clipping the bleeding artery?
    ---
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  • reyhan@nyshh.comreyhan@nyshh.com
    Thank you!
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