Home Health ICD-9/ICD-10 Alert

Published on Sat May 20, 2006 PDF

V58.3 will soon expand.

You don't need a separate code to report every wound you dress.

Listing V58.3 (Attention to surgical dressings and sutures) inappropriately is a common coding mistake, says Sparkle Sparks, MPT, HCS-D, COS-C, with Redmond, WA-based OASIS Answers Inc. Coders often include V58.3 when they are providing care for non-surgical wounds, she says.
 
Bottom line: Report V58.3 only when you are providing attention to surgical dressings or sutures.

Because this code exists to help describe care of surgical wounds, some coders feel the need to include a code to describe the care of other wounds. Coding the wound itself is enough to indicate that you are providing wound care, says Sparks.

Example: Your patient has a non-healing ulcer of the foot. You will be providing daily wound care and dressing changes. Report 707.15 (Ulcer of the lower limbs, except decubitus, ulcer of other part of foot) for this patient, not V58.3. The ulcer code indicates all routine care provided to this wound.

Nix V58.3 For Complications
 
Mistake: Don't list V58.3 for complicated surgical wounds, even if you will be providing dressing changes, says Sparks. You should report V58.3 only for routine surgical wounds, she says. If there's anything wrong with the wound at all, report a complication code from the 900 series, she advises, and don't report V58.3.

Example: This patient was referred to your agency for care of an abdominal surgical wound that dehisced and became infected with staphylococcus. Code for this patient as follows, says clinical consultant Judy Adams RN, BSN, HCS-D with Charlotte, NC-based LarsonAllen:

• M0230a: 998.32 (Disruption of external operation wound);
• M0240b: 998.59 (Other postoperative infection); and
• M0240c: 041.10 (Staphylococcus, unspecified).

New code alert: Look for V58.3 to expand to five digits in October. The new codes will include V58.30 (Encounter for change or removal of nonsurgical wound dressing), V58.31 (Encounter for change or removal of surgical wound dressing) and V58.32 (Encounter for removal of sutures).