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routine postpartum pt. with HIV + (AIDS)

  1. #1
    Default routine postpartum pt. with HIV + (AIDS)
    Medical Coding Books
    How do you code a postpartum visit with a women who has HIV?
    My coding manager is staying neutral, but we are having a meeting and I would like to show everyone these answers from the AAPC.

    Coders have been coding this scenario for years (not sure if they are getting paid because I am just the coder) and they are using the 647 code (I do not have my book with me so excuse me while I use just my memory). At the beginning of ICD-9, the guidelines have specific instructions as how to code this. Guidelines state for a pt who has been "admitted" for an "HIV complication" should have the 647, 042, followed by the specific complication assigned.

    It appears that coders in my facility believe that the HIV is the specific complication for a postpartum visit and they assign the 647 code. I tried to use the analogy of a pt. who has skin cancer of the arm with a CC of headache, that cancer would not be primary. Like in this case I believe per coding guidelines that a postpartum pt. is still considered routine postpartum because there are no HIV complications or postpartum complications. Can someone please share their coding experiences who code this or have coded this scenario daily? All input welcomed!

    Leilani , CPC

  2. #2
    Madison Area Chapter in Madison WI
    Here's what I ask myself.
    Why is the patient being seen? Postpartum care.

    Were there complications related to HIV?
    If no, how can you code something that doesn't exist.

    If yes, was there exam, decison making, or treatment related to HIV complications?

    If I understand your situation correctly, there were no HIV complications, therefore no HIV complication dx would be appropriate. I hope this is helpful.
    Happy Coding, Claudia

    Claudia Yoakum-Watson, CPC
    Coding, Compliance, & Reimbursement Solutions
    [email] - website

  3. #3
    Thank you very much for your response. Does anyone else agree or disagree? Can I have more input to present to my manager?

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