Wiki Aftercare for Hip Replacement Z Code

[dballard2004]

I have a question regarding the use of aftercare codes...if a patient has a right hip replacement due to OA and the hospitalist sees the patient the next day to access and coordinate therapies for disposition planning, wouldn't the correct primary dx be Z47.1 for aftercare following a hip replacement? The coder chose the OA, but wouldn't that be resolved with the hip replacement?Any guidance appreciated. This is the hospitalist side only, not the surgeon. Thanks.

 

[thomas7331]

It's really hard to answer your question without having seen the documentation from which the codes are being assigned. But typically, I would expect the aftercare code to be used for post-operative care visits (usually by the surgeon) where the primary reason for the visit is to monitor the progress of the recovery from surgery. Hospitalists are usually not surgeons or orthopedic specialists and, in my experience, when a hospitalist is involved in a patient's care during a hospital stay it is for the medical management of other conditions unrelated to the surgical procedure. If that's the case, then the diagnosis coding of the hospitalist's service should reflect the condition that is primarily responsible for that physician's work, which by my guess is likely not going to be purely orthopedic post-operative care.

 

[dballard2004]

It's really hard to answer your question without having seen the documentation from which the codes are being assigned. But typically, I would expect the aftercare code to be used for post-operative care visits (usually by the surgeon) where the primary reason for the visit is to monitor the progress of the recovery from surgery. Hospitalists are usually not surgeons or orthopedic specialists and, in my experience, when a hospitalist is involved in a patient's care during a hospital stay it is for the medical management of other conditions unrelated to the surgical procedure. If that's the case, then the diagnosis coding of the hospitalist's service should reflect the condition that is primarily responsible for that physician's work, which by my guess is likely not going to be purely orthopedic post-operative care.

Thanks