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V55.1 vs 536.49

  1. Default V55.1 vs 536.49
    Medical Coding Books
    Hi,
    If a patient has a gastrostomy tube and the tube falls out. It is not known how it came out.

    Some coders feel the correct Dx. 536.49 other gastrostomy complications, where others feel V55.1 because there is no complication to the tube so therefore only V55.1 should be used.

    Any thoughts please

    Marci Klaubauf, CPC

  2. #2
    Location
    Stuart, Florida
    Posts
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    Default
    The following link contains the answer to your question!

    http://www.cditalk.com/content.php/2...-Complications
    Vanessa Mier, CPC

  3. Default
    Quote Originally Posted by Mklaubauf View Post
    Hi,
    If a patient has a gastrostomy tube and the tube falls out. It is not known how it came out.

    Some coders feel the correct Dx. 536.49 other gastrostomy complications, where others feel V55.1 because there is no complication to the tube so therefore only V55.1 should be used.

    Any thoughts please

    Marci Klaubauf, CPC
    You would use V55.1 as there was no complication to the tube. See the below coding clinic third quarter 1997:
    "VOLUME 14 THIRD QUARTER

    NUMBER 3 1997, Page 8



    Dislodged PEG Tube with Replacement



    Question: A nursing home patient presents to the emergency room with the complaint that her PEG tube has fallen out. Physical examination reveals that the stoma is still intact, but the tube has become dislodged. The nursing staff believe it is possible the patient, in her confused state, may have pulled the tube out. The tube was replaced and the patient returned to the nursing home. What is the appropriate diagnosis code for the emergency room visit? Complications, gastrostomy is indexed to code 997.4. However, some coders feel this is a mechanical complication because the tube is displaced, so they would assign code 996.59. Other coders feel there is no complication present and this is just an encounter for tube replacement, so they would assign V55.1. Please clarify.



    Answer: Assign code V55.1, Attention to gastrostomy, as the principal diagnosis. There are no complications with the gastrostomy, therefore, no complication code is appropriate for this case."

    Hope this helps.

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