ICD-10 Encounter Dx vs Amputation Dx
Amy Patterson
Description
Collection
Title:
ICD-10 Encounter Dx vs Amputation Dx
Creator:
Amy Patterson
Date:
9/28/2015
Text:
Through all the preparation for the ICD-10 coding that begins in a just a few short days, our office wanted to get some insight from others preparing as well. Sometimes information overload can lead to overthinking and overanalyzing and it's nice to get additional clarity.
The traumatic amputation codes come with initial, subsequent and sequela options. After much review we feel that providing a prosthesis (or prosthetic items) would be considered subsequent care, using the 'D' level amputation ICD-10 codes. The initial 'A' code only seems to be applicable if we were to participate in a post-op with a rigid dressing, shrinkers, sheaths, etc.
But then we came across the Z44 codes regarding encounters for fitting/adjusting a prosthesis. Now we are considering that the Z44 code should be the primary code (possibly) on the Detailed Written Order and the amputation (or congenital deficiency) diagnoses should be secondary. We have found that the Z code is an 'aftercare visit code' and the cover situations when the initial treatment of a disease has been performed and the patient requires continued care during the healing or recovery phase, or for the long-term consequences of the disease. In all relevancy a prosthesis is a 'long-term consequence' but a 'visit' vs a 'receipt of item?'
We've also noted that under Guidelines for Outpatient Services it states that 'list first the ICD-10-CM code for the diagnosis, condition, problem, or other reason for encounter/visit shown in the medical records chiefly responsible for the services provided.' This then seems as if the amputation/defect code is first and then the possible (if at all) Z44 code.
Has anyone found how this should specifically be done in the realm of prosthetic care?
Amy Patterson
Office Manager
Abilities Unlimited
245 Parkside Drive
Colorado Springs CO 80910
Ph: (719) 520-9700
Fax: (719) 520-0218
Note: This communication may contain information that is legally protected from unauthorized disclosure. If you are not the intended recipient, please note that any dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this in error, you should notify the sender immediately by telephone or by return e-mail and delete this message from your computer.
The traumatic amputation codes come with initial, subsequent and sequela options. After much review we feel that providing a prosthesis (or prosthetic items) would be considered subsequent care, using the 'D' level amputation ICD-10 codes. The initial 'A' code only seems to be applicable if we were to participate in a post-op with a rigid dressing, shrinkers, sheaths, etc.
But then we came across the Z44 codes regarding encounters for fitting/adjusting a prosthesis. Now we are considering that the Z44 code should be the primary code (possibly) on the Detailed Written Order and the amputation (or congenital deficiency) diagnoses should be secondary. We have found that the Z code is an 'aftercare visit code' and the cover situations when the initial treatment of a disease has been performed and the patient requires continued care during the healing or recovery phase, or for the long-term consequences of the disease. In all relevancy a prosthesis is a 'long-term consequence' but a 'visit' vs a 'receipt of item?'
We've also noted that under Guidelines for Outpatient Services it states that 'list first the ICD-10-CM code for the diagnosis, condition, problem, or other reason for encounter/visit shown in the medical records chiefly responsible for the services provided.' This then seems as if the amputation/defect code is first and then the possible (if at all) Z44 code.
Has anyone found how this should specifically be done in the realm of prosthetic care?
Amy Patterson
Office Manager
Abilities Unlimited
245 Parkside Drive
Colorado Springs CO 80910
Ph: (719) 520-9700
Fax: (719) 520-0218
Note: This communication may contain information that is legally protected from unauthorized disclosure. If you are not the intended recipient, please note that any dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this in error, you should notify the sender immediately by telephone or by return e-mail and delete this message from your computer.
Citation
Amy Patterson, “ICD-10 Encounter Dx vs Amputation Dx,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/237687.
