Approach this as if you were an auditor ... what specified aftercare is this?
I speak from experience when I say to start with why the patient requires skilled services, then consult the Index and let that point you to the correct code in the Tabular; any process that starts with the Tabular or relies on a cheat sheet or ignores current coding guidelines will lead to regret.
Susan Winokur, HCS-D, BCHH-C | Southwest Medical Part of OptumCare Senior Medical Coder, Home Health
8655 South Eastern Avenue, Las Vegas, NV 89123 USA T +1 702-838-0644 Susan.Winokur@optum.com smalv.com
Encounter for other specified aftercare. If you look up that code in the ICD-10 tabular list, you’ll see note that instructs you to “code also condition requiring care." In other words, you should not submit Z51.89 as a patient’s sole diagnosis—if you can help it—because on its own, this code might not adequately support the medical necessity of therapy treatment. Thus, using it as a primary diagnosis code could lead to claim denials.
One thing I failed to mention is that problems will arise if agencies are relying on the General Equivalence Mappings (GEMS) for ICD-10 coding. The following is a snip from page 3 of CMS's publication "GENERAL EQUIVALENCE MAPPINGS FREQUENTLY ASKED QUESTIONS." https://www.cms.gov/medicare/coding/icd10/downloads/gems-crosswalksbasicfaq.pdf
How to I post to the board? I have a question about coding in M1016 and M1017, my patient had an ileostomy reversal because it was temporary, I don't have clue have to start coding this, can someone please advise Julia
Julia Heckl RN, Administrator Woodland Village Home Health 425 Manor Drive Suring, WI 54174 Phone- 920-842-4132 Fax- 920-842-4133
Comments
I speak from experience when I say to start with why the patient requires skilled services, then consult the Index and let that point you to the correct code in the Tabular; any process that starts with the Tabular or relies on a cheat sheet or ignores current coding guidelines will lead to regret.
Susan Winokur, HCS-D, BCHH-C | Southwest Medical
Part of OptumCare
Senior Medical Coder, Home Health
8655 South Eastern Avenue, Las Vegas, NV 89123 USA
T +1 702-838-0644
Susan.Winokur@optum.com
smalv.com
Julia
Julia Heckl RN, Administrator
Woodland Village Home Health
425 Manor Drive
Suring, WI 54174
Phone- 920-842-4132 Fax- 920-842-4133
Susan Winokur, HCS-D, BCHH-C | Southwest Medical
Part of OptumCare
Senior Medical Coder, Home Health
8655 South Eastern Avenue, Las Vegas, NV 89123 USA
T