Expand



Go Back   AAPC Forum > Medical Coding > Diagnosis Coding
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools
  #1  
Old 07-14-2010, 08:43 AM
Michelle2179 Michelle2179 is offline
New
 
Join Date: Apr 2007
Posts: 6
Michelle2179 is on a distinguished road
Default Old CVA with residual left sided weakness

Assesment: CVA with left sided weakness (unspecified dominant or nondominate sided)

By definition, hemiparesis = weakness, therefore I would conclude that the correct code would be 438.20 (late effect of CVA with hemiparesis/hemiplegia). There are many debates, with out a concise direction, for this code I would appreciate some guidance, please

Should I code 438.20
-OR-
438.89 and 780.79
Reply With Quote
  #2  
Old 07-14-2010, 12:22 PM
gost's Avatar
gost gost is offline
Guru
 
Join Date: Apr 2007
Location: Charleston, WV
Posts: 237
gost is on a distinguished road
Default

The definition of hemiparesis is the partial paralysis of one side of the body, not weakness. Go with 438.89. Look at the tip under 438.89 in the ICD-9 expert. Use 728.87 as your secondary code for residual weakness due to CVA.
Reply With Quote
  #3  
Old 07-14-2010, 12:37 PM
Michelle2179 Michelle2179 is offline
New
 
Join Date: Apr 2007
Posts: 6
Michelle2179 is on a distinguished road
Default

From the medical dictionary and stroke.about.com, the following are defined:

Hemiplegia: partial paralysis of one side of the body
Hemiparesis: muscle weakness on one side of the body
Reply With Quote
  #4  
Old 07-14-2010, 01:02 PM
gost's Avatar
gost gost is offline
Guru
 
Join Date: Apr 2007
Location: Charleston, WV
Posts: 237
gost is on a distinguished road
Default

Quote:
Originally Posted by Michelle2179 View Post
From the medical dictionary and stroke.about.com, the following are defined:

Hemiplegia: partial paralysis of one side of the body
Hemiparesis: muscle weakness on one side of the body
While sites like About.com and Wikipedia can sometimes be good starting points for research, they are by not alaways reliable resouirces for detailed information. The best reference for diagnosis coding is the ICD-9 CM. Again, refer to the coding tips under the entry for 438.89. In addition, look up "paresis" in any medical dictionary. Paresis is the partial loss of or impared movement.
Reply With Quote
  #5  
Old 07-22-2010, 11:21 AM
arizona1 arizona1 is offline
Expert
 
Join Date: Apr 2007
Posts: 324
arizona1 is an unknown quantity at this point
Default

Have also defined Hemiparesis as weakness on one side of the body and use 438.20.

Looking at the definition on the tabular list is does only state "paralysis"

Does anyone know if CMS has accepted this as weakness?
Reply With Quote
  #6  
Old 07-22-2010, 12:53 PM
JulesofColorado JulesofColorado is offline
Expert
 
Join Date: Apr 2007
Posts: 251
JulesofColorado is on a distinguished road
Default

This is from The Coding Clinic, First Quarter 2005 Page: 13


"Question:

Please provide clarification on the correct code assignment for a residual deficit of muscle weakness secondary to late effect of cerebrovascular accident. We have a difference of opinion on whether this should be coded to code 438.2x, Late effects of cerebrovascular disease, hemiplegia/ hemiparesis. What is the appropriate code assignment for residual weakness that is a late effect of CVA?


Assign code 438.89, Other late effects of cerebrovascular disease and code 728.87, Muscle weakness, for residual muscle weakness secondary to late effect of cerebrovascular accident."
__________________
Julianne Sheetz, CPC
Reply With Quote
  #7  
Old 07-22-2010, 01:02 PM
arizona1 arizona1 is offline
Expert
 
Join Date: Apr 2007
Posts: 324
arizona1 is an unknown quantity at this point
Default

thank you!
Reply With Quote
  #8  
Old 07-19-2012, 01:13 PM
LoveCoding LoveCoding is offline
New
 
Join Date: Apr 2007
Posts: 3
LoveCoding is on a distinguished road
Default Old CVA w/residual left sided weakness

I just had this same DX. In the encoder I put late/effect/CVA/hemiplegia/ unspecified (because it doesn't say whether left side was dominant or not. The code comes up 438.20 and tabular confirms Hemiplegia/hemipararesis (Late effect of CVA).
Reply With Quote
Reply

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off




Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 07:55 AM.


Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2015, Jelsoft Enterprises Ltd.
Copyright ©2015, AAPC