Home Health ICD-9/ICD-10 Alert
Look to Aftercare for Pathologic Fracture
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Question: Our patient has a healing pathologic fracture of her right femur due to senile osteoporosis. We will be providing skilled nursing, physical therapy, and occupational therapy. She also had a vertebral pathologic fracture due to her senile osteoporosis 1 year ago. How should we code for her?
North Carolina Subscriber
Answer: Code for this patient as follows:
Your focus in this multi-disciplinary case is aftercare for your patient’s pathologic hip fracture, so you’ll list V54.23 in M1020a, paired with 733.14 in M1024.
Case mix: Acute fractures are the one condition you’re still able to report in M1024, but you won’t earn any case mix points for this patient. That’s because she doesn’t also have a pressure ulcer and isn’t receiving IV or parenteral nutrition at home. But listing 733.14 may impact your risk adjustment.
Follow this with 733.01 for your patient’s senile osteoporosis. Finally, list a history code for her vertebral pathologic fracture because it will impact the care your agency provides.
In ICD-10, you won’t list aftercare codes for fracture care provided in home health. Instead, you’ll list the fracture code with seventh character “D” to indicate subsequent encounter. So, you would list the following codes for this patient:
Home Health ICD-9/ICD-10 Alert
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