HCS-D new guidelines 100% Accurate!
Non-healing surgical wounds - ANSWERS*no code for nonhealing surgical wound
-use: T81.89x-, other complications of procedures, NEC
*If not healing due to Infection
-use: T81.4xx-, infection following a procedure
*If closed at one time and no longer closed
-use: T81.3-, disruption of wound, NEC
Aftercare codes - ANSWERSonly for surgery/procedures
*NOT related to an injury/trauma
Pressure Ulcers - ANSWERS*must be DX by doctor
-can be staged by documentation
*(OASIS) Pressure Ulcer with skin graft is NOT a PU anymore it's a SURGICAL
WOUND
-use: Unstageable PU
Pressure Ulcers - ANSWERS*Gangrene coded 1st - I96
*Combo code - L89.-
-does NOT need additional code for location
*Do NOT code sages 1 & 2 when healed, 3 & 4 when closed
*Do not reverse stage
-once a stage always a stage
Diabetic Ulcer
-with Gangrene? - ANSWERS*Code DM code E__.621, followed by location Lcode
*DM Gangrene has combo code
-E__.52
NO aftercare codes for... - ANSWERS*Trauma injuries of any kind
*Do NOT use Zcodes for care of trauma injury
-use 7th characters
*7th character determined by TYPE of care needed
, *Continue to code the injury until HEALED
"with" guideline - ANSWERS*Presumes a casual relationship between 2 conditions and
should be coded as related, even if the Dr doesn't explicitly link them
-DM with
*cataract
*Charcot's joint
DM, CKD, and HTN - ANSWERSE11.22 (DM w/CKD)
I12.9 (HTN CKD)
N18.9 (CKD stage)
or
I12.9 (HTN CKD)
E11.22 (DM w/CKD)
N18.9 (CKD stage)
Unspecified DM with Ketoacidosis? - ANSWERSdo NOT assume, query physician
Insulin Pump Failure - ANSWERSSEQUENCE:
T85.6- (Mechanical complication)
Type of DM & problem (combo code)
T38.3x6- (underdosing of insulin)
Y63.6 (underdosing and non-administration of necessary drug)
Glaucoma, NOT assumed with DM but... - ANSWERSif Dr links the 2 "Diabetic
Glaucoma"
-use: E__.39- (type __ DM w/other diabetic ophthalmic complications)
-then: H42.- (Glaucoma in DM2 classified elsewhere)
Phys says: Borderline DM, Latent DM, Prediabetes - ANSWERSR73.03- (Prediabetes)
-NOT considered DM
Type I DM, ketosis prone - ANSWERSE10.--
Postpancreatectomy DM - ANSWERSSEQUENCE:
E89.1- (postprocedural hypoinsulinemia)
E13 code
Z90.41- (aquired absence of pancreas)
Z79.4 (insulin
Z79.84 (anti-glycemics)
E13.-- - ANSWERSOther DM
-secondary DM NEC
Non-healing surgical wounds - ANSWERS*no code for nonhealing surgical wound
-use: T81.89x-, other complications of procedures, NEC
*If not healing due to Infection
-use: T81.4xx-, infection following a procedure
*If closed at one time and no longer closed
-use: T81.3-, disruption of wound, NEC
Aftercare codes - ANSWERSonly for surgery/procedures
*NOT related to an injury/trauma
Pressure Ulcers - ANSWERS*must be DX by doctor
-can be staged by documentation
*(OASIS) Pressure Ulcer with skin graft is NOT a PU anymore it's a SURGICAL
WOUND
-use: Unstageable PU
Pressure Ulcers - ANSWERS*Gangrene coded 1st - I96
*Combo code - L89.-
-does NOT need additional code for location
*Do NOT code sages 1 & 2 when healed, 3 & 4 when closed
*Do not reverse stage
-once a stage always a stage
Diabetic Ulcer
-with Gangrene? - ANSWERS*Code DM code E__.621, followed by location Lcode
*DM Gangrene has combo code
-E__.52
NO aftercare codes for... - ANSWERS*Trauma injuries of any kind
*Do NOT use Zcodes for care of trauma injury
-use 7th characters
*7th character determined by TYPE of care needed
, *Continue to code the injury until HEALED
"with" guideline - ANSWERS*Presumes a casual relationship between 2 conditions and
should be coded as related, even if the Dr doesn't explicitly link them
-DM with
*cataract
*Charcot's joint
DM, CKD, and HTN - ANSWERSE11.22 (DM w/CKD)
I12.9 (HTN CKD)
N18.9 (CKD stage)
or
I12.9 (HTN CKD)
E11.22 (DM w/CKD)
N18.9 (CKD stage)
Unspecified DM with Ketoacidosis? - ANSWERSdo NOT assume, query physician
Insulin Pump Failure - ANSWERSSEQUENCE:
T85.6- (Mechanical complication)
Type of DM & problem (combo code)
T38.3x6- (underdosing of insulin)
Y63.6 (underdosing and non-administration of necessary drug)
Glaucoma, NOT assumed with DM but... - ANSWERSif Dr links the 2 "Diabetic
Glaucoma"
-use: E__.39- (type __ DM w/other diabetic ophthalmic complications)
-then: H42.- (Glaucoma in DM2 classified elsewhere)
Phys says: Borderline DM, Latent DM, Prediabetes - ANSWERSR73.03- (Prediabetes)
-NOT considered DM
Type I DM, ketosis prone - ANSWERSE10.--
Postpancreatectomy DM - ANSWERSSEQUENCE:
E89.1- (postprocedural hypoinsulinemia)
E13 code
Z90.41- (aquired absence of pancreas)
Z79.4 (insulin
Z79.84 (anti-glycemics)
E13.-- - ANSWERSOther DM
-secondary DM NEC
