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Wiki Dx coding for corrected congenital malformations

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Dialmam

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What are folks using for f/u visits with corrected congenital malformations. For example, patient comes in s/p PFO closure and report states "no obvious residual shunt". Do you code 745.5 or V13.65?

Do you get paid using V13.65? According to the guidelines, you shouldn't code conditions that aren't currently present, even if they had it in the past. However, congenital malformations are different.

Thanks!
 
If the congenital malformation is stated as corrected upon the patient's arrival, I would go with the V code regardless of reimbursement. However, if the patient was being seen to have the correction, you would use the regular code for the malformation to be corrected.
As I understand it, Diagnosis codes never determine reimbersement, they only provide support for why the tests were done, and the CPT codes are what pay goes by.

Hope this helps! :)
 
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