Home Health ICD-9/ICD-10 Alert

Published on Sun Apr 24, 2011 PDF

Know which seventh digit is generally off-limits for home health.

When ICD-9 becomes ICD-10 in 2013, you'll need to know how to categorize your care by encounter.

Check out this common diagnosis to discover what you'll report after October 1, 2013.

When providing care for a patient's infected surgical wound, you currently report 998.59 (Other postoperative infection).

ICD-10 difference: When you make the switch to ICD-10, you'll report infected surgical wounds with T81.4xx-

Indicate the encounter: ICD-10 codes can include up to seven characters, and in this case you'll need all seven. The fifth and sixth digits will be "x," which leaves room for future expansion of this sub-category, but you will need to choose a seventh digit to indicate whether this is an initial encounter when reporting a code from the T81 category. Your choices are:

• A: Initial encounter -- The patient is receiving active treatment;
• D: Subsequent encounter -- The patient has already received active treatment, and is now receiving routine care during the healing or recovery phase; or
• S: Sequela -- The patient is being treated for complications or conditions that arise as a direct result of an injury. This is equivalent to what we currently call "late effects."

Connection: In the scenario described in the article starting on page 25, you would report T81.4xxS because the patient is being treated for a complication of her surgery.