Home Health ICD-9/ICD-10 Alert
Know The Score With Case Mix V Codes
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V55.x codes don't belong in M0246. The points you'll receive when reporting case mix codes V55.0 (Tracheostomy), V55.5 (Cystostomy) and V55.6 (Other artificial opening of urinary tract) will vary depending on episode timing and the number of therapy visits involved. Here's a breakdown: Episode 1 or 2 with 13 or fewer therapy visits: V55.0: 4 points V55.5: 6 points V55.6: 6 points Episode 1 or 2 with 14 or more therapy visits: V55.0: 4 points V55.5: 23 points V55.6: 23 points Episode 3 or higher with fewer than 13 therapy visits: V55.0: 4 points V55.5: 4 points V55.6: 4 points Episode 3 or higher with 14 or more therapy visits: V55.0: 0 points V55.5: 23 points V55.6: 23 points Mistake: Never list the case mix V55.x codes in M0246, says Jun Mapili, PT, MAEd, with Global Home Care in Troy, MI. V codes shouldn't be coded in M0246; instead, list them in the first six positions in M0230 and M0240, he says.
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