Good day everyone,
Let’s go over the correct answers for the ICD-9 and ICD-10 codes for the following scenario:
Your patient was trimming his hedges and dropped the electric trimmer on his foot, almost severing his foot at the ankle. The surgeon completed the amputation as a mid-calf amputation and home health was ordered for amputation aftercare. The patient has a long history of diabetic PVD.
M1020a: V58.43 (Aftercare following surgery for injury and trauma)
M1022b: 250.70 (Diabetes with peripheral circulatory disorders)
M1022c: 443.81 (Other specified PVD)
M1022d: V49.75 (Lower Limp amputation status, below the knee)
M1022e: V58.31 (Encounter for change or removal of surgical wound dressing)
Rationale: V58.43 is an appropriate code for aftercare following traumatic amputation. Case-mix points are also available for diabetes as an other diagnosis. Amputation status codes are considered pertinent to the care plan and are coded unless there is a complication. Since home care has been ordered for care of the wound, you will also add dressing change code.
M1021a: S98.021D (Traumatic amputation partial of right foot at ankle level, subsequent encounter)
M1023b: E11.51 (Diabetes with peripheral angiopathy without gangrene)
M1023c: Z48.01 (Encounter for change or removal of surgical wound dressing)
M1023d: Z89.511 (Lower Limb amputation status, below the knee)
M1023e: W29.3xxD (contact with a powered garden and outdoor hand tool and machinery)
Rationale: Aftercare codes for traumatic injuries are non-existent in ICD-10-CM. Instead, you will use the actual injury code with a 7th character to indicate sequelae of injuries. The external cause code for how the injury occurred is required in ICD-10, at this time. (This may change and may become more like the E-Codes, but as of now it’s a requirement)
Let’s discuss your codes.