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diagnosis codes

Rebeka Posted Wed 18th of December, 2013 13:11:45 PM

. Would the correct diagnosis codes for this be:v42.1, V58.44, 401.9 and 758.0 in that order?

Patient was seen in the cardiac catheterization center for a right heart catheter and heart biopsy. The patient has a history of a heart transplant and the biopsy is done yearly on the anniversary of the transplant. The patient has additional conditions of hypertension and Trisomy 21.

SuperCoder Answered Wed 18th of December, 2013 16:38:59 PM

The listed codes look appropriate. Many LCDs list V42.1 as a code that supports medical necessity for a right heart cath. The aftercare code is fine as a way to show the reason for the encounter. ICD-9 guidelines state, “Code all documented conditions that coexist at the time of the encounter/visit, and require or affect patient care treatment or management.” Check the documentation, but it’s likely the HTN and trisomy 21 were documented as relevant in treatment/medication/care/etc. decisions.

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