Wiki aftercare codes

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KarinQuiterio2023

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Patient is coming in status post a total knee replacement; can the aftercare codes be used as a standalone code or do we code the reason for the total knee (ie, osteoarthritis) as well to help differentiate the reason for the TKA.
 
karinquiterio said:
Patient is coming in status post a total knee replacement; can the aftercare codes be used as a standalone code or do we code the reason for the total knee (ie, osteoarthritis) as well to help differentiate the reason for the TKA.
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You never code the preop dx as the reason for post op care when it no longer exists. The code for aftercare following joint replacement and the Z code for the joint replaced is all you code.
 
Z codes can be primary codes? I thought these were the equivalent to V codes and when we billed with just aftercare codes our claims were denied?
 
Z codes are equivalent to the V codes but at no time was it said that these could not be used as first listed codes. It is correct to use Z codes first listed when the documentation supports the use. Aftercare following surgery is a perfect example. You do not use the condition that the surgery was performed for since it no longer is an issue for the patient except of things lke neoplasms. So a Z code for aftercare or follow up is appropriate. Perhaps the reason you did not get reimbursement is that is was in the global, the it is not the presence of the Z or V code, it is the fact that the service provided is part of global.
 
No it wasn't a global issue, we had problems with Medicare Advantage plans refusing to pay when we used V codes as primary diagnosis for aftercare visits or annuals.
 
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