This scenario was taken from the Decision Health Home Health ICD-9-CM Diagnosis Coding Pro Manual, 2013 version, on page 1304: Case Scenario #2.
Here is the scenario: “An 83-year-old female is admitted to the HHA following discharge from the hospital. The patient is seven days S/P left total hip replacement due to OA in both hips. She developed a mildly exudative wound infection that tested positive for staph aureus of her surgical incision and was discharged from the hospital on IV antibiotics. This is the patient’s initial episode of home health care. Physician’s orders: Daily SN visits for three weeks to treat surgical wound, to monitor for s/s of infection, administer antibiotics daily for 21 days; and teach patient’s daughter to perform IV administration and wound care. Therapy for gait training and strength exercises two times a week for four weeks Ambulation is non-weight bearing status of her LLE. Patient able to perform supervised pivot transfers with contact guard assistance in and out of bed. Her daughter will be staying with her until her mobility improves.:
M1020: 998.59 (other post-operative infection)
M1022: 041.11 (MSSA in diseases classified elsewhere)
M1022: v58.81 (Fitting and adjustment of vascular catheter)
M1022: V54.81 (the surgical incision is infected, not the joint)
V1022. V43.64 (identifies the hip joint)
V1022: 715.35 (patient has OA localized, not specified whether primary or secondary, pelvic region).
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