Home Health Coding – History of Pressure Ulcers


Question: Should we go for V67.x (Follow-up examination following surgery) rather than a condition code for a healed stage 2 ulcer that we’re following for observation owing to newly healed status but are recertifying for observation? Should we make use of the follow-up code in lieu of the actual condition that now is resolved?

Answer: According to Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, consultant and principle of Selman-Holman & Associates in Denton, Texas, A V67.x code for following surgery would not be correct in this case.

Here’s why: The patient didn’t have surgery for the stage 2 ulcer. The only code from the category that you might think about of using is V67.09. That’s quite a non-specific code. You can’t code the stage 2 ulcer once it’s resolved.

The next issue at hand is whether the care you’re providing (observation and assessment) would be included, says Selman-Holman. Consider the time span from healing to the end of the previous episode.

Is there a probable fluctuation in the patient’s condition? Has the patient had repeated skin integrity problems or changes in caregivers that lead you to think that the patient is at increased risk of developing more ulcers? What other diagnoses does the patient have that show an increased risk for skin breakdown? Your answers to these queries must support the need for skilled care in home health coding.

Code V13.3 (Personal history of diseases of skin and subcutaneous tissue) is the apt history code for a patient who has a history of ulcers.

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Source by Jan Mater Cavegnero

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