cva

how to code cva's in home health care

re: cva

Coding for home health for the primary and secondary codes to describe a CVA involve the reason home health is there. Category 438 Late effects of cerebrovascular disease is usually assigned for home health patients.
Note: This category is to be used to indicate conditions in 430-437 as the cause of late effects. The "late effects" include conditions specified as such, or as sequelae, which may occur at any time after the onset of the causal condition. Under Medicare home health PPS, the major exceptions to ICD-9-CM coding guidelines involve the use of acute stroke codes and symptom codes from Chapter 16. Agencies should recognize the appropriate uses of Chapter 16 symptom codes but not overuse them. Under Medicare PPS coding guidelines, the acute stroke diagnosis still applies as long as the patient continues in the original post-stroke rehabilitation phase. With this coding, additional, secondary diagnoses to describe any resulting problems are included (342.90, 784.5). If the patient was beyond the rehabilitation phase but had similar problems that affected the plan of treatment, then the stroke would be coded from category 438, which contains codes for problems that don’t have to be mentioned separately.