ICD-9 Coding for AAA - Status Post Repair

[heatherwinters]

A primary care patient was seen in our office for a followup. He had an Abdominal Aortic Aneurysm repair done by another physician. Primary care physician evaluated patient's Hypertension, Osteoarthrosis, and the surgery site. We are not specifically managing the patient's post operative care, that will be done by the clinician who performed the surgery. Assessment Reads: HTN, OA, AAA. If the patient is status post repair, would you still use the code for Abdominal Aortic Aneurysm 441.4 or is there a personal history code that you would use instead? I have been unable to locate one that sounds correct. Thank you for your input.

 

[sue37412]

You only code for what your doctor is seeing(treating) the patient for.

 

[heatherwinters]

ICD-9 Status Post AAA Repair

He is seeing patient for a follow up, one of the Dx is AAA, however it has been repaired. I am having problems discerning what would be the appropriate icd-9 code to accurately reflect that portion of his visit.

 

[lisammy]

Use could use a V15.1 or V43.4 if you really felt you wanted to use it in your dx

 

[ram]

As per ICD guideline, 'status post' indicate that 'a patient is either a carrier of a disease or has the sequelae or residual of a past disease or condition & also status code is distinct from a history code. The history code indicates that the patient no longer has the condition'. Owing to this, a history code cannot be choosen and so a direct code should be taken. Eg: CAD s/p CABG implies 414.00 and V45.81.

 

[lynnepadilla]

Aaa

Are you sure the AAA is not still present? The physician lists it as a current diagnosis. In most cases, when an AAA is repaired, it does not remove the AAA itself, therefore it is still present. I would code it as such. Per the Guidelines, you should code all conditions that have the potential to affect decision making or care. I would code 441.4 because the condition was addressed by the physician and the incision site was examined.

 

[mvrangel]

ACL with Status Post Failed ACL

Patient came in for Pre-op for ACL repair. Patient previous had a Status post Failed ACL. and is going to have ACL sx again. Previously had sx 6months,. Can I and should I code the status post failed ACL sx and if So which codes would appropiate.


Thanks
Veronica Rangel

 

[FractalMind]

What about V12.59 + V15.1? Can both be reported?

 

[klebart123]

Would an Aftercare Code Apply?



Would V58.73 apply here, in the hospital setting just after surgery? I was thinking on that first, then a history code.

Anyone else with input into this code?

 

[klebart123]

AAA Repair Response



Just to clarify, I was responding to the question on AAA repair, not the newer one about the ACL.

 

[MacksMom]

Status Post Surgery

There are too many surgeries for the ICD9 to have a status post code for each of them, so V45.89 can be used for status postoperative NEC. It's what I use (when there isn't a specific status post code for the surgery we performed) if the patient isn't having issues and our Doc's are just rounding status post surgery. Don't let the description under V45.89, in the tabular list, scare you away from using it. ICD9 could not list all the surgeries there either, but if you Google V45.89 you will find many articles written about the usage of V45.89, and there are a lot of procedures/surgeries that are covered by this code. Hope this helps.

Jennifer Haney, CPC, CCC

 

[kakaskie]

As per ICD guideline, 'status post' indicate that 'a patient is either a carrier of a disease or has the sequelae or residual of a past disease or condition & also status code is distinct from a history code. The history code indicates that the patient no longer has the condition'. Owing to this, a history code cannot be choosen and so a direct code should be taken. Eg: CAD s/p CABG implies 414.00 and V45.81.

Based upon what guidelines? I need to determine when it is proper to code for an AAA when it has been repaired. If a resection has been done, then I can see where the AAA no longer exists, but the insertion of a stent, the AAA still exists until that time that it shrinks away. Are there any official guidelines concerning Active/Status Post AAA, etc. Thank you

 

[kakaskie]

Status post AAA Repair

Is there an "official" guideline that states coding for an AAA that has been repaired stating whether is should be coded as 441.-- or V12.--. It makes sens if it is resected that a V code would be appropriate but if it is just a stent, does it not still exist? Although it may shrink over time with the stent. I would like to see the "official" guideline, there is nothing on CMS website or anywhere I have searched so far. Thank you!