Wiki Aftercare code for an MI after 4 weeks

[sandya]

Hi...per Medicare guidelines, we are not to use the old MI code I25.2, for encounters after 4 weeks, when the pt is still receiving care related to the MI. We are to use the "aftercare" code. However, they don't state what the aftercare code is. Does anybody know? We are thinking I23.8. Any suggestions? thank you Sandy

 

[sandya]

could that be a Z code...Z51.89???

 

[consultingbykristin]

I don't think I23.8 would be appropriate because that's for complications following an acute MI.

the Coding Guidelines indicate encounters occurring while the MI is equal to, or less tham, four weeks old, including tramsfers to another acute setting or a postacute seeting, and the patient requires continued care..use code(s) from category I21. After 4 weeks, the appropriate aftercare code is assigned. It's not until it's old/healed we use I25.2.

Interestingly the guidelines don't state what the aftercare codes are or ranges.

An MI that's still within 4 weeks and undergoing care codes to I21.3 MI (acute) NOS

Aftercare following surgery on circulatory system is Z48.812. If patient had bypass you would also use Z95.1

Then there's the generic other aftercare code of Z51.89

Hope that helps...weird that they don't direct us to which aftercare codes to use

 

[sandya]

thanks...so basically if there are no complications after 4 weeks, then it's old/healed and we would use I25.2 for the follow up encounter. Is that what you would do?

 

[consultingbykristin]

If that's the physician's documentation, I would. He does have to state that it's healed or indicate if there's ongoing issues.

 

[sandya]

ok, but then, what if it's not healed? I21 is for a current MI...we couldn't use that? Confusing!!!