The use of V-code home health care coding on OASIS is considered an “assignment of last resort.”
A V-code refers to a treatment protocol for a known disease, such as dialysis for kidney disease requiring, physical therapy for a fractured hip or medication monitoring for Coumadin or Theophyline.
The underlying reason for the v-code procedure code must accompany a V code to support the treatment being performed. V-codes indicate a
reason for an encounter. V codes are used to deal with occasions when circumstances other than a disease or injury are recorded as “diagnoses” or “problem”.
An example…
An 85-year-old independent female sustained a left hip fracture resulting in a hospital stay for an open reduction with internal fixation. Following her discharge from the hospital, she is admitted to a skilled nursing facility (SNF) where she is scheduled to be discharged from the SNF to her home where she will receive skilled therapy services. Her physician orders non-weight bearing activity to her left lower extremity with supervised pivot transfers and contact guard assist in and out of bed.
Skilled Nursing: The HHA did not receive an order from the patient’s physician to provide skilled nursing services. The initial assessment visit by the HHA did NOT identify skilled nursing needs.
Therapy Need: The physician ordered physical therapy (PT) for gait evaluation/training and strengthening exercises three times per week for four weeks. The patient’s ambulation is limited due to the non-weight bearing status of her left leg. This is her first episode of home health care. Twelve therapy visits are ordered by her physician for this episode of care.
M1022: V57.1, Other physical therapy. M1024: 781.2, Abnormality of gait
V57.1 is selected as the patient’s primary diagnosis and assigned to M1022. The rehabilitation code V57.1, Other physical therapy, qualifies as the patient’s M1022 primary diagnosis because the focus of the patient’s current home health plan of care is to provide rehabilitation through therapeutic physical therapy. Coding guidelines for V57 instructs the HHA to use an additional code to identify the patient’s underlying condition on M1024 Code 781.2, Abnormality of gait, is identified as the patient’s underlying condition on M1024.
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