Full Answer
you can never assign a dx that does not exist at the time of the visit. Aftercare codes are used as long as the provider is doing something due to the surgery such as dressing changes, if it is just a survelliance encounter to see that the patient is doing as expected it is a followup.
Most patients are encouraged to walk with a walker or crutches the same day or next day after their hip or knee revision surgery. Patients who cannot go home after one or two nights may be discharged to a skilled nursing facility or may stay in the hospital for a few more days until it is safe to go home.
more specific status. Z codes Z42 through Z51 are aftercare codes for which a secondary Z status code may be useful. In cases involving joint replacement surgery, a secondary Z status code should indicate which joint was replaced. For example, if you were treating a patient who had a total knee replacement, you would want to submit Z47.1, Aftercare
Their corresponding character in ICD-10-CM is:
Encounter for orthopedic aftercare following surgical amp; code to identify the limb amputated (Z89.-)
code to identify the limb amputated ( Z89.-)
Example 1: A patient with severe degenerative osteoarthritis of the right hip, underwent right hip arthroplasty. MDS item I0020B, the primary diagnosis is Z47.1 - Aftercare following joint replacement surgery and MDS item J2310: Hip replacement, partial or total, should be checked. This would fall under the Major Joint Replacement or Spinal Surgery PDPM Clinical Category.
According to the CMS ICD-10-CM Official Guidelines for Coding and Reporting for Fiscal Year 2021, the aftercare Z codes should not be used for aftercare of traumatic fractures. For aftercare of a traumatic fracture, assign the acute fracture code with the appropriate 7th character. Here are examples of the difference:
Z47.89 is a valid billable ICD-10 diagnosis code for Encounter for other orthopedic aftercare . It is found in the 2021 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2020 - Sep 30, 2021 .
Z47.89 is exempt from POA reporting ( Present On Admission).
DO NOT include the decimal point when electronically filing claims as it may be rejected. Some clearinghouses may remove it for you but to avoid having a rejected claim due to an invalid ICD-10 code, do not include the decimal point when submitting claims electronically. See also: Aftercare Z51.89 see also Care.