Home Health ICD-9/ICD-10 Alert
Strike Out Old Stroke Codes
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Question: For a patient with diagnosis of cerebrovascular accident with hemiparesis (hemiplegia), do I code the CVA (436) and hemiparesis (438.20) or just the 438.20? -- New York Subscriber Answer: A code from the 438 category (Late effects of cerebrovascular disease) should be used for each late effect the patient has from a CVA. Code 436 (Acute, but ill-defined, cerebrovascular disease) excludes CVA and hasn't been used for patients with a CVA since 2004. Home care coders shouldn't use the acute CVA codes (430-437) at all, except when completing M0190 and M0210. With your patient, you should determine whether the hemiparesis is affecting his dominant or non-dominant side, rather than coding unspecified with a "0" in the fifth digit.
Home Health ICD-9/ICD-10 Alert
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