Late effect guidelines. How does a coder determine and sequence late effect and principal diagnosis in ICD9 This is probably a very basic question but as a rookie coding student, its confusing to me right now. Well, its confusing to everybody so dont feel bad. This is probably one of the first guidelines that you get taught in most coding courses and it just baffles everybody. So lets look at the little answer sheet we created for you. Here we go. Go ahead and slide down a little bit to that answer part. As a general rule,.
Dont forget that when you do ICD coding, you code the main reason why they walked in the door. And then here are some examples. This person has a how do you say that Laureen Kyphosis. Alicia Kyphosis, okay. I was going to say that but I didnt want to screw it up, you know Kyphosis due to polio. Now, 138 is your polio code but 737.41 is the late effect code. And I dont even have to look at my code book to know that. I just know that polio.
Is an early number code, late effect codes are higher numbers. So they came in with the kyphosis that comes first and the reason our cause goes as a supporting code. But to get to it, we have to use the main term late in the index. So when you see something that says late effect or due to, go to your first word. Its late that you look up in your index. Otherwise, well be coding an acute or current condition. The dysphagia just means theyre having problems swallowing due to CVA which is a cerebrovascular.
Medical Coding Late Effect Guidelines
Accident. And thats pretty common with people who had a stroke. So 438.82, I know thats the dyphagia code and 787.20 is the late effect. 438 is due to the CVA. So 438.82, late effect to the cerebrovascular disease, dysphagia used and it says in the guidelines. Use additional code to identify the type of dysphasia. If none, theres a range to look at. So all your ICD9 official guidelines for the coding section are theyre actually listed in there. Laureen But on that one, if you dont mind me jumping in, this is whats known as a.
Combo code. Sometimes with late effect codes, you can tell the story with one code. Other times, you need two. But this was a great example because the 438.2 actualy tells the whole story. It tells that its a late effect of a CVA and that their problem today is dysphagia. But we are told in the ICD tabular to also code an additional code that just qualifies the type of dysphagia. Because youre like, Why do I need this other code Its already saying dysphagia. Well, theres different types and thats what this is. Youll see.
That a lot with diabetes too like diabetic retinopathy. Itll tell you, Okay, but what type of diabetes Is it insulindependent or whatever So they want you to do that second code. So this is an example of where the one code really told the late effect story but per ICD guidelines, were being told to code an additional one to round the story out. Alicia Yeah, I would like to tell the viewers, if youre painting a picture, thats the highlight. Youre painting in the highlights. So more example of late effects coding. You.
Got aphasia due to previous CVA. Now dysphagia is difficulty in swallowing. Aphasia is inability or you know, the absence of swallowing. So you got 438.11, one code only is needed here because the description, like the other one, it tells you the whole story and theres no guideline telling you that you need to use additional codes. You got late effect, this CVA disease or cerebrovascular disease and its aphasia. Traumatic athritis due to old fracture of left ankle. Now heres whare youre going to use more than one code. Youve got arthritis and its traumatic arthritis, 716.17. What.
Caused the traumatic arthritis 905.4 is the cause of the arthritis. Ataxia due to CVA, 438.84. It says it all. You dont need any more coding to go with that. Now, mental retardation due to a viral encephalitis, 319 is mental retardation and 1′.0 is the encephalitis, the viral encephalitis. Youre directed to use both of those codes. And each one of those examples that we gave you is examples of late effect coding where sometimes you have one code and sometimes you have two. Thats where it gets confusing for people. But if you just.
Follow the guidelines, you can do it. Heres some little reminders for you. Again, this will be in the replay so you can refer back to this. Late effects usually needs two codes. Thats the common rule. But there are exceptions. The condition or nature of what is going on is coded first, then you will code the late effect second. Theres no time limit with late effects code. Something could have happened at birth and theyre having a late effect when theyre 16 or 30 or 50. The residual condition is the effect that is produced because of the illness or.
Injury. From Find A Code, this was an example, 737.41 and 319. That 319 is mental retardation. The first code, my kids learned because they call each other that. Not always will a second code be needed. If the documentation does not tell you why or what the residual condition is caused from then you only code the late effect. Okay, that confuses some people. If the manual instructs you to code in a different order then you follow the manual. So you think, Well, the rules from is this. But if you see something that indicates code first.
Then that code goes first. If you see an indication that says use in addition then that code goes second. If theres no code available in ICD9 manual then you only use one code. That happens,a lot, too. Watch for codes that are expanded to the 4th or 5th digit and include the late effect or residual into the description. They throw those in. That 5th digit tells you what the residual is sometimes. So you want to make sure, when youre looking at the code, that you look at everything.