What about the aftercare codes we currently use...seems to me those explain the care LTC facilities are providing the resident, rather than procedure codes.
A code from subcategory R65.2 can never be assigned as a principal diagnosis.Codes for underdosing should never be assigned as principal or first-listed codes.An external cause code can never be a principal (first-listed) diagnosis.
Sequela (Late Effects)
Coding of sequela generally requires two codes sequenced in the following order: the condition or nature of the sequela is sequenced first. The sequela code is sequenced second. Bill Roush comment: A Principal that ends with seventh character S breaks this Guideline!For rehabilitation services following active treatment of an injury, assign the injury code with the appropriate seventh character for subsequent encounter as the first-listed or principal diagnosis.7th character "A", initial encounter is used for each encounter where the patient is receiving active treatment for the condition.7th character "D" subsequent encounter is used for encounters after the patient has completed active treatment of the condition and is receiving routine care for the condition during the healing or recovery phase.Bill Roush comment: using seventh character for initial encounter for LTC stay breaks this Guideline!
And then there is also the specific directions in Coding Clinic 4th Quarter 2012 "Long Term Care Coding Issues"! My MAC had never heard of them the last time I checked!