Total or Hemi Arthroplasty to Repair a Fracture
We were not able to be at the Coding Summit in early August to hear of the change in interpretation.
I have looked for guidance in writing this morning, hoping it would be in the Sept. issue of Coding Pro, to no avail.
Our current printed materials say to use the joint replacement codes, not the fracture codes (ICD-10 Study Guide).
I have had 2 charts in the last week that have had hemi arthroplasties and I am confused as to how to code them.
I am wondering if Megan Gustafson or Tricia Twombly could clarify this for those of us who didn't hear it first hand?
Alison
Alison Fisk RN BSN HCS-D COS-C
Coding RN
VNA Home Health Hospice
50 Foden Road
South Portland, Maine 04106
207-780-8624(main)
207-400-8744 (direct)
207-772-0698(fax)
fiska@emhs.org
I have looked for guidance in writing this morning, hoping it would be in the Sept. issue of Coding Pro, to no avail.
Our current printed materials say to use the joint replacement codes, not the fracture codes (ICD-10 Study Guide).
I have had 2 charts in the last week that have had hemi arthroplasties and I am confused as to how to code them.
I am wondering if Megan Gustafson or Tricia Twombly could clarify this for those of us who didn't hear it first hand?
Alison
Alison Fisk RN BSN HCS-D COS-C
Coding RN
VNA Home Health Hospice
50 Foden Road
South Portland, Maine 04106
207-780-8624(main)
207-400-8744 (direct)
207-772-0698(fax)
fiska@emhs.org
Comments
Continue to assign the injury code, for example S72.001D (Fracture of unspecified part of neck of right femur, subsequent encounter for closed fracture with routine healing), for patient who underwent a joint replacement to treat a hip fracture.
The aftercare code Z47.1 (Aftercare following joint replacement surgery) is not appropriate in these types of scenarios, confirmed Nelly Leon-Chisen, director of coding and classification for the American Hospital Association, which publishes the Coding Clinic's quarterly updates. Leon-Chisen confirmed this guidance during her session at DecisionHealth's 14th annual Home Health Coding Summit.
This guidance amounts to a substantial change from how the care of joint replacements done to treat fractures is coded. Previous wisdom held that once the fractured bone is surgically excised and replaced with a prosthetic joint, the fracture no longer exists and the aftercare code is the only logical choice. - Megan Gustafson (mgustafson@decisionhealth.com)
Traci Strauss RN, COS-C, HCS-D
Clinical Reimbursement Specialist
209-914-3521