Coding, Classification and Reimbursement

Aspirin use in LTC

  • 1.  Aspirin use in LTC

    Posted 13 days ago
    I am curious if anyone can shed light on what are the correct diagnosis codes to assign for medication orders related to Aspirin use?

    This is the question:

    Admitting Nurses have been documenting Aspirin use for many reasons: "for blood thinner", "to prevent blood clot", "for prophylactic", or sometimes, no dx at all as Discharge Papers do not mention what Aspirin is for.

     

    In each case, here is what I've been doing:

    1.  If a resident  comes in with Dx of S/P CVA or Hx of CVA,  I assign  Z79.82 and under comments I put "Aspirin Therapy for CVA prophylaxis"

    2.  If a resident comes in for surgical aftercare.  I assign  Z79.82 and under comments I put "Aspirin Therapy for DVT prophylaxis"

    However, recent Pharmacy Consultant Review identified that "Long Term (current) use of Aspirin IS NOT A DIAGNOSIS" and ADON was advised to obtain clarification for all Aspirin orders and assign a correct diagnosis.


    Any advice is greatly appreciated!



    ------------------------------
    Bill Roush, RHIA, BSHI, AHIMA-Approved ICD-10-CM Trainer
    ------------------------------


  • 2.  RE: Aspirin use in LTC

    Posted 13 days ago
    As coders, we can not diagnose.  Therefore, the only code shown is "Long Term (current) use of Aspirin".  Otherwise, we have to query the physician to see why he/she ordered the medication.  If the ADON wants something else, she can do a phone order with the physician to clarify on the clinical side what is needed for the pharmacist.  Then as coders, we have what we need on the health information side.  This is how I cover myself with our nursing staff.

    ------------------------------
    Barbara Hagan
    Health Information Coordinator
    ------------------------------



  • 3.  RE: Aspirin use in LTC

    Posted 12 days ago
    Thanks Barbara!

    ------------------------------
    Bill Roush, RHIA, BSHI, AHIMA-Approved ICD-10-CM Trainer
    ------------------------------