When the patient returns to have stiches removed or follow up or rehab due the hardware removal you will use the complication T code for the painful hardware and append the 7th character D. The Z47.2 would be used if the hardware was not indicated as painful and had not been placed due to an injury.
So yes for hardware removal from a trauma fracture you use the D, E, or F seventh character. Thank you for the clarification on all that. And I thought I understood it all! My understanding is that Z47.2 is to be coded for removal of "internal" fixation devices.
A: Based on a discussion by the AAOS ICD-9 and CPT Coding Committee, removal of hardware used for a specific fracture type—regardless of the number of screws, plates, rods or incisions—would only be coded once.
I would use Z47.2- encounter for removal of internal fixation device, as well as the original injury code for sequela. I'm curious why you would use the injury code with the sequel and not subsequent?
698A: Other mechanical complication of other specified internal prosthetic devices, implants and grafts, initial encounter.
0QPH45ZRemoval of External Fixation Device from Left Tibia, Percutaneous Endoscopic Approach. ICD-10-PCS 0QPH45Z is a specific/billable code that can be used to indicate a procedure.
ICD-10-CM Code for Encounter for removal of internal fixation device Z47. 2.
V54. 01 Encounter for removal of internal fixation device.
The claim should be coded as follows: Removal of Hardware: 20680 - Removal of implant; deep (e.g., buried wire, pin, screw, metal band, rod or plate)
"T84. 84XA - Pain Due to Internal Orthopedic Prosthetic Devices, Implants and Grafts [initial Encounter]." ICD-10-CM, 10th ed., Centers for Medicare and Medicaid Services and the National Center for Health Statistics, 2018.
Pain due to internal orthopedic prosthetic devices, implants and grafts, initial encounter. T84. 84XA is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM T84.
ICD-10 code Z98. 890 for Other specified postprocedural states is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
An external fixation device may be used to keep fractured bones stabilized and in alignment. The device can be adjusted externally to ensure the bones remain in an optimal position during the healing process. This device is commonly used in children and when the skin over the fracture has been damaged.
Encounter for other orthopedic aftercareICD-10 code Z47. 89 for Encounter for other orthopedic aftercare is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
0SHF05ZICD-10-PCS Code 0SHF05Z - Insertion of External Fixation Device into Right Ankle Joint, Open Approach - Codify by AAPC.
Follow-up. The difference between aftercare and follow-up is the type of care the physician renders. Aftercare implies the physician is providing related treatment for the patient after a surgery or procedure. Follow-up, on the other hand, is surveillance of the patient to make sure all is going well.
Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00 -Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
The 2022 edition of ICD-10-CM Z46.89 became effective on October 1, 2021.
Z47.2 is a valid billable ICD-10 diagnosis code for Encounter for removal of internal fixation device . 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 .
A type 2 Excludes note represents 'Not included here'. An Excludes2 note indicates that the condition excluded is not part of the condition it is excluded from but a patient may have both conditions at the same time. When an Excludes2 note appears under a code it is acceptable to use both the code and the excluded code together.
NEC Not elsewhere classifiable#N#This abbreviation in the Tabular List represents “other specified”. When a specific code is not available for a condition, the Tabular List includes an NEC entry under a code to identify the code as the “other specified” code.
A type 1 Excludes note is a pure excludes. It means 'NOT CODED HERE!' An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of “other specified” codes, the terms are a list of the various conditions assigned to that code.
When an Excludes2 note appears under a code it is acceptable to use both the code and the excluded code together. A “code also” note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction. The sequencing depends on the circumstances of the encounter.
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.
The Z47.2 code is an aftercare code and you will not use that if this is aftercare of an injury. In addition you will not code the injury with an S because this is not a residual of the injury, this is something new caused by the presence of the hardware. so the appropriate approach is the complication code with the A as the extender. Painful hardware is not a complication of the injury that is why it is not coded as sequel. This is a new issue that is coded as a complication. When the patient returns to have stiches removed or follow up or rehab due the hardware removal you will use the complication T code for the painful hardware and append the 7th character D.#N#The Z47.2 would be used if the hardware was not indicated as painful and had not been placed due to an injury.
If you look at the "Excludes 1" which is a hard exclude, meaning that you can't code it with Z47.2 it lists removal of external fixation, infection or mechanical complication.
Painful hardware is not a complication of the injury that is why it is not coded as sequel. This is a new issue that is coded as a complication. When the patient returns to have stiches removed or follow up or rehab due the hardware removal you will use the complication T code for the painful hardware and append the 7th character D.
Use secondary code (s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code. Type 1 Excludes.
The 2022 edition of ICD-10-CM T84.84XA became effective on October 1, 2021.