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Decoding I-10 Dilemmas - LTACH

Published on 

Wednesday, April 6, 2016

 | Miscellaneous 

Dilemma:

A patient was recently admitted to an acute care hospital diagnosed with an infection from a vascular access device.  The patient was then discharged from the acute care hospital and admitted to a long-term acute care hospital (LTACH) to continue antibiotics for the infection.  What 7th character would be assigned for the principal diagnosis to the LTACH, initial encounter (A) or subsequent encounter (D)?

Solution:
The principal diagnosis for the LTACH admission is (T82.7XXA) for Infection/Inflammatory Reaction due to Other Cardiac/Vascular Device, Initial Encounter.  The patient is still receiving active treatment for the infection of the vascular device so the 7th character is an A.  Examples of active treatment are:  surgical treatment, emergency department encounter, and evaluation and continuing treatment by the same or a different physician. 
Information Source(s):

  • ICD-10-CM Official Guidelines for Coding and Reporting, Chapter 19,  Application of 7th Characters
  • 1Q, Coding Clinic, 2015, under the heading, Applying the 7th Character for Continued Treatment in Other Care Settings
Article Author: Debbie Rubio, BS MT (ASCP)
Debbie Rubio, BS MT (ASCP), was the Manager of Regulatory Affairs and Compliance at Medical Management Plus, Inc. Debbie has over twenty-seven years of experience in healthcare including nine years as the Clinical Compliance Coordinator at a large multi-facility health system. In her current position, Debbie monitors, interprets and communicates current and upcoming regulatory and compliance issues as they relate to specific entities concerning Medicare and other payers.

This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.