Home Health ICD-9/ICD-10 Alert

Published on Mon Oct 26, 2009 PDF

Question: Our new patient has an infection on his left above-knee amputation stump that is positive for methicillin resistant staphylococcus aureus. He also has diabetic peripheral vascular disease (PVD) and hypertension. We are providing wound care. How should I code for him?

Answer: To code for this patient, list the following:

M0230/M1020a: 997.62 -- Amputation stump complication; infection (chronic)

M0240/M1022b: 041.12 -- Methicillin resistant Staphylococcus aureus [MRSA]

M0240/M1022c: 250.70 -- Diabetes with peripheral circulatory disorders

M0240/M1022e: 443.81 -- Peripheral angiopathy in diseases classified elsewhere

M0240/M1022f: 401.9 --  Essential hypertension; unspecified.

Don't miss: When you look up 997.62, you'll see a note to "Use additional code to identify the organism." 041.12 indicates the organism causing the infection (Staphylococcus aureus) and also shows that it is a methicillin-resistant strain.

Because the physician has linked the patient's PVD with his diabetes, you must use manifestation code sequencing to report these diagnoses. Place the diabetes code first, choosing your fourth digit to indicate that the patient has a peripheral circulatory disorder as a result of his diabetes. Code 443.81 is the correct manifestation code for PVD as a result of diabetes.

You don't indicate that the physician specified whether the patient's hypertension is malignant or benign. Absent these details, you must list the unspecified hypertension code (401.9).

Reporting the V49.76 amputation status code to indicate the amputation status is not appropriate because you shouldn't list a status code with a complication code unless otherwise stated.