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Q:

Is there a “timeline” to using I69 codes? For example:  My new patient had cognitive deficits and Dysphagia and had CVA in 2016. Do I use I69 codes or R codes?

A:

There is no time limit on when a sequela code can be used. “Late effects” include neurologic deficits that persist after initial onset of the condition. If these cognitive deficits and dysphagia were caused by the CVA that occurred in 2016, you would continue to code using the I69 category as long as the deficits persist and you can relate them back to the CVA.

Since the dysphagia would potentially count as an SLP comorbidity under PDPM, I would also ensure it is accurately reflected in the care plan for patient centered interventions associated with the particular condition relating to the neurological deficits from stroke.

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Blog by Stacy Baker, OTR/L, CHC, RAC-CT, Director of Audit Services, Proactive Medical Review

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