Q: (Port and Catheter Status Codes - these are V codes).
What ICD-9 codes are used to report that a patient has a port for receiving medications
(antibiotics, chemotherapy, infusions, etc.)?
Not the CPT codes for placement of port.
Also, what ICD-9 codes are used to report catheters both urinary and cardiac currently
in place?
A: So, Sandi what I did was I went in and pulled this all out of Find-A-Code pretty
much.
You have to know that it’s a V code, first of all, and then to look these up, you have
to have the right keyword to look them up especially if you’re using an electronic,
like an encoder versus your manual.
But V07 is going to be your first place.
The key is prophylactic or treatment measures.
So, if a person is going to get chemo and that type of thing, what are they getting
it for?
They’re getting it for prophylactic purposes, so V07 is going to be your launching point.
Keep in mind there is certain long-term prophylactic drugs, that there’s other V codes for, and
that’s why this [has] excludes.
Let’s look at what the prophylactic means: A prophylactic is any kind of a preventive
measure.
A prophylactic may be a medication, drug, device, or treatment designed and used to
ward off a disease or other unwanted consequence.
And the examples that they’re giving are: tetanus shot, antivenin, immune globulin,
or fluoride to provide protection and prevent a potential condition or disease from developing.
They also make note: The prophylactic measures reported within this category do not include
the removal of a potentially cancerous organs, and so on and so forth…
This is different, in this category the V07 we’re looking at things, like, one of the
choices is chemotherapy, which would be V07.3, but you’re still going to have to add on
to that.
Here is also some that is V07.51 – use of selective estrogen receptor modulators (SERMs)
and these are the different estrogen stuff that they give to women that have, like, breast
cancer which is treatment.
And then you get into what we were talking about in the question was status codes.
Whenever you’re dealing with somebody that has an artificial opening, that’s going
to be a V44, so we’re talking about an “–ostomy” of any kind; it can be an ileostomy, it can
be a colostomy.
Again, there are several kinds of -ostomies and you’re going to find them in this V44
section.
The other one, V45.0 - cardiac device in situ; so any type of cardiac device that has been
added or is being used.
V45.1 - renal dialysis status; so if a person is getting plugged in for dialysis, this is
the area that you’re going to find that.
Making a point of V45.2 – postprocedural status – and that is one which I added because
a lot of people don’t think of this – presence of cerebrospinal fluid drainage device; a
shunt, valve or device in situ.
Again, these are any time that you are putting something into a patient so that they can
put things into you or let things come out of you and drain; this is that area that you’re
going to be looking at.
They even have presence of contraceptive devices.
And then one, again, a lot of people forget is available is V45.7 which additional digit,
acquired absence of an organ.
That would be if a person had their spleen removed because they’d had an automobile
accident.
If they give you a kidney transplant, they don’t actually take out one of the kidneys,
they leave them in there.
So that’s not an acquired absence of an organ, you may not have known that.
V45.86 Bariatic surgery status – Again, you can imagine how important this is to be
in your record if you go in to have a procedure done and then they find that you’ve got
a gastric band.
Or they go to give you medication, or what if they went to pump your stomach because
you had ingested something, it’s going to be pretty important that they know you’ve
had a gastric bypass surgery.
V58.6 Long-term (current) drug use – That’s where you get long-term insulin use or long-term
antibiotic use (V58.62).
The last one and the one that I think gets missed so often is amputation status because
they abbreviate it, and most of the time I see that in that area that I showed you in
that chart that the patient has the blood pressure and all the vital signs.
And then off in the corner it will say, BKA (below knee amputation) and it will be all
caps and you don’t even think about it because this is in the vital signs; but below knee
amputation and that’s a V code and it also carries an HCC, so it is something that very
important to always be documented.
It affects the care of the patient if they have an amputation especially a limb.
You can have finger amputation, stuff like that, don’t carry HCCs, but a lower limb
definitely would and especially if it has something to do with maybe a diabetic manifestation
and then they had an amputation of below the knee or above the knee.
So, those are the main ones that you need to look for, but your main key terms that
you need to know is status – when you’re looking up devices and things like this being
in a person, and then up here is prophylactic, if there’s some medication or something
that’s being used on a long-term basis.
You’re going to find your codes lumped in all in those areas.
So, I hope that was helpful to you and you were able to glean how to find those codes
from that.
V codes can intimidate people but once you get in there and start using them, it starts
clicking.