DVT Coding

[ruthan]

How are people coding DVT and DVT lower extremity for standing lab orders for Coumadin Therapy. I have been using the 453.40 for DVT only and the DVT lower extremity (order does not state acute or chronic) I use the 453.42 because the unspec. leads back to acute.

 

[JulesofColorado]

I would code 453.40 (unless order states exact location of lower extremity) and V58.61.

 

[DKColson1928]

Dvt

My physicians code DVT 453.40 for patients being treated (i.e. dissolving the clot using coumadin) is it ok to code 453.40 or should I code as history of DVT?? Does anyone have the coding guidelines for this? When is it coded as current vs. history of....Thanks

 

[mitchellde]

If the patient is here for a lab draw because they are on coumadin then the appropriate code first listed is V58.83 followed by V58.61.

 

[ruthan]

I think it should be up to the Drs. to tell you if it is a history of DVT. If you are looking at orders like I do there is nothing to tell you if it is current or history. But if you were coding from a chart then it might be different. That is my opinion anway

 

[mitchellde]

Are working in an outside lab?

 

[cosita]

My physicians code DVT 453.40 for patients being treated (i.e. dissolving the clot using coumadin) is it ok to code 453.40 or should I code as history of DVT?? Does anyone have the coding guidelines for this? When is it coded as current vs. history of....Thanks

If there is treatment being directed towards the problem than you code it at a current condition.
Coumadin is an anticoagulant, not an thrombolytic, so patients will take it to prevent a clot from forming.
Another way to think of it would be like breast cancer and tamoxifen. So long as the patient is on the tamoxifen you will code it as a current condition. Even if theyre a few years out from surgery, chemo etc.

 

[serhaug]

prophylaxis versus treatment

Most of the time standing orders for Coumadin therapy are in response to a history of a condition. I would NOT assume the condition is acute.

In response to cosita below, the Coumadin is being used as prophylaxis, not treatment, so it would not be assumed that the condition is current. As always, you have to rely on the documentation and code appropriately, and if you need further clarification, make sure you get the physician to clarify and document the clarification appropriately.

Remember, too, there is a new code for chronic DVT, so the choices are not limited to acute DVT and history, but again you have to code appropriate to the documentation and request clarification when necessary.

Also, the comparison of breast cancer on tamoxifen therapy is like comparing apples to oranges. Cancer has a whole set of rules unto itself and is should not be necessarily compared with other disease processes.