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Home Health ICD-9/ICD-10 Alert

You Be the Coder:

Look to Intensity of Services

Published on Mon Aug 23, 2004 Print Friendly and PDF PDF

Question: You admit a patient for a home care episode following surgical removal of a neoplasm of the descending colon and a resulting colostomy. And, the patient has stable type II diabetes, treated with oral medication. The patient will need to be taught to care for the colostomy and will not need chemotherapy, since the tumor was completely removed. How would you code this case?

Answer: You should code the following:
 

  • M0230 - V55.3 (Attention to artificial openings; colostomy)
     
  • M0240 - V10.05 (Personal history malignant neoplasm; large intestine); V58.42 (Aftercare following surgery for neoplasm); 250.00 (Diabetes mellitus; type II).

    Use V55.3 since the treatment the home health agency is providing is directed at the colostomy care, says Cushing, Okla.-based home health coding consultant Laresa Boyle. Because the neoplasm is gone, you would use V10.05 in M0240, but if the patient were receiving chemotherapy, you would code the neoplasm instead of the history of the neoplasm, she says.

    The aftercare code will account for the assessment and teaching the nurse will need to do, and the diabetes code is included as a secondary diagnosis "because I'm sure the nurse will monitor this," Boyle says.

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