ICD9 Codes
Here's the code you must sequence first.
You might be aware of what late effects are in ICD-9, but how do you deal with them in ICD-10-CM? In fact, sequela is the new term in ICD-10 and by the sequela extension of "S" substitutes the late effects categories in ICD-9-CM. Read this article to know how your ICD-9 codes will change when ICD-10 implementation hits.
Example: Current late effect ICD-9 codes 905.1 (Late effect of fracture of spine and trunk without mention of spinal cord lesion) will become M48.43xS (Fatigue fracture of vertebra, cervicothoracic region, sequela of fracture).
Follow these coding tips before you report a late effect code, so that your practice is never "late" collecting ethical reimbursement.
Medical Coding and Billing Tip 1: Review the Definition
"Sequela" is the new term used for late effects. Keep in mind that a late effect is the residual effect that takes place after the acute period of an illness or injury has terminated. For example, you'll report a sequela ICD-10 codes for the scar formation after a burn.
Medical Coding and Billing Tip 2: Time for Sequela Varies
You won't find any time limit stating when you can start using a late effect code. Why not? For the reason that late effects vary. The residual effect may be obvious early, like in the case of a cerebral infarction, or it may take place months or years later, like an effect due to a previous injury.
Medical Coding and Billing Tip 3: Generally, You Need 2 Codes -- In This Order
When you code late effects, you'll normally need two codes. You must sequence the condition or nature of the late effect first. You would code the late effect code second.
For instance, you might report M81.8 (Other osteoporosis without current pathological fracture) followed by E64.8 (Sequelae of other nutritional deficiencies [calcium deficiency]). The condition is osteoporosis, and the late effect is the calcium deficiency.
Exceptions: You may come across instances when you will report the late effect followed by a manifestation code.
A different situation is when the late effect has been expanded (at the fourth, fifth, or sixth character) to reflect the manifestation. For example instance, check out I69.191 (Dysphagia following nontraumatic intracerebral hemorrhage). The "following" means the definition includes the late effect.
You must never report the code for the acute phase of an illness or injury, even though that is what led to the late effect. Also, evade the activity codes Y93.- or External Cause Status codes Y99.- with sequela(e) codes.
Medical Coding and Billing Tip 4: Here's How to Use Extension "S"
In case you're looking at injury sequela(e) from ICD-10-CM's Chapter 19, you'll find most of the codes have a 7th character, which involves the code extension of "S." While using extension "S," you are required using both the injury code that precipitated the sequela and the code for the sequela itself. Bottom line: You'll add the "S" only to the injury code, not the sequela code.
You might be aware of what late effects are in ICD-9, but how do you deal with them in ICD-10-CM? In fact, sequela is the new term in ICD-10 and by the sequela extension of "S" substitutes the late effects categories in ICD-9-CM. Read this article to know how your ICD-9 codes will change when ICD-10 implementation hits.
Example: Current late effect ICD-9 codes 905.1 (Late effect of fracture of spine and trunk without mention of spinal cord lesion) will become M48.43xS (Fatigue fracture of vertebra, cervicothoracic region, sequela of fracture).
Follow these coding tips before you report a late effect code, so that your practice is never "late" collecting ethical reimbursement.
Medical Coding and Billing Tip 1: Review the Definition
"Sequela" is the new term used for late effects. Keep in mind that a late effect is the residual effect that takes place after the acute period of an illness or injury has terminated. For example, you'll report a sequela ICD-10 codes for the scar formation after a burn.
Medical Coding and Billing Tip 2: Time for Sequela Varies
You won't find any time limit stating when you can start using a late effect code. Why not? For the reason that late effects vary. The residual effect may be obvious early, like in the case of a cerebral infarction, or it may take place months or years later, like an effect due to a previous injury.
Medical Coding and Billing Tip 3: Generally, You Need 2 Codes -- In This Order
When you code late effects, you'll normally need two codes. You must sequence the condition or nature of the late effect first. You would code the late effect code second.
For instance, you might report M81.8 (Other osteoporosis without current pathological fracture) followed by E64.8 (Sequelae of other nutritional deficiencies [calcium deficiency]). The condition is osteoporosis, and the late effect is the calcium deficiency.
Exceptions: You may come across instances when you will report the late effect followed by a manifestation code.
A different situation is when the late effect has been expanded (at the fourth, fifth, or sixth character) to reflect the manifestation. For example instance, check out I69.191 (Dysphagia following nontraumatic intracerebral hemorrhage). The "following" means the definition includes the late effect.
You must never report the code for the acute phase of an illness or injury, even though that is what led to the late effect. Also, evade the activity codes Y93.- or External Cause Status codes Y99.- with sequela(e) codes.
Medical Coding and Billing Tip 4: Here's How to Use Extension "S"
In case you're looking at injury sequela(e) from ICD-10-CM's Chapter 19, you'll find most of the codes have a 7th character, which involves the code extension of "S." While using extension "S," you are required using both the injury code that precipitated the sequela and the code for the sequela itself. Bottom line: You'll add the "S" only to the injury code, not the sequela code.
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