ICD-10-CM Specific Coding Guidelines - Methicillin-Resistant Staphylococcus Aureus (MRSA)

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that's what I'm talking about all right

you ready to talk about Mera let's get

into it but what is merca well we know

it's a certain

infectious and or parasitic disease we

do know that because it's in the section

right and Mera is the acronym

for methan resistant stafl cacus arus so

it's a very difficult form bacteria it's

a very difficult bacteria to treat and

it's

resistant to penicillin or any kind of

medication in that family now it's in

the title meyan

resistant that's our clue all right now

we have a couple of guidelines that I

want to draw your attention

to guideline C1 e1a when you are coding

for

Mera

right use a combination code for the

infection and the causal agent if you

there is a combination code use it right

use it in lie of

b95.62 and on the left this is what one

of those combination codes look like see

under staff laus

infection

underneath you have methan susceptible

and methan

resistant these are the combination

codes well we're only talking about Mera

right resistant so a49.02 this is a

combination code that is related to a

staffle

infection all right this is an

example now if there is no combination

code then the sequencing order is first

you code the

infection then you use the um General

mer M code

b95.62 Mera infection as the cause of

disease classified

elsewhere all right hopefully you

understand that and remember don't code

a resistance to penicillin with this

b95.62 you don't have don't code it with

that don't code it with with the um A4

9.0 too because it's

understood right it's in the

name all

right I've got one more guideline to

draw your attention to guideline C1

e1c and this is um

Mera carrier with no current infection

so if the patient is a carrier of the

Mera

um disease use

z22

322 all right so we're going to say Mera

bacteria so if the person if this

patient is a carrier but doesn't have

the infection they carry the bacteria

but don't have the infection then there

you go z22

322 and don't code it

as having the condition they're just the

carrier

now let's go ahead and test your

knowledge right let's do it we we got

our

guidelines let's see what we can do here

which icd10 CM codes best describe the

above encounter a

l141 9

b95.62 b

b95.61 l

0241 n c l2. 419 Z1 6.11 and D

b95.62 l2.

415 Barbara a 55-year-old female patient

is admitted to the hospital with

red swollen and

nonhealing

absess on her

leg the patient has been on an

antibiotic for 7even days and the

abscess has has not improved it is now

extremely painful and warm to the touch

the physician suspects that it is caused

by

Mera The Physician orders a culture and

sensitivity test to confirm the

diagnosis which came back positive for

Mera all right

coders your time begins now and don't

forget re go to your guidance your

guidelines guidelines are your

friend

all right you all are doing amazing yes

indeed all right so I'm going to do my

due diligence and I'm going to highlight

my key words red swollen nonhealing

abscess on her

leg

absess warm to

touch physician

suspects Mera and it came back positive

for Mera so inventory is red swollen

non-healing abscess on leg warm to touch

suspects Mera and Mera positive all

right

so I think we have two diagnoses here we

have non-healing abscess on leg and we

also have Mera positive all others are

integral the redness is integral to the

non-healing abscess on leg the swelling

non-healing a access on leg and Mera in

fact redness and swollen or swelling are

both related to Mera and the non-healing

absess on leg warm to touch related to

both and the Physicians suspecting Mera

is an indicator or indication that the

patient may have

Mera so these are my

two diagnoses all right coders can you

eliminate anything on site if you can

you are the bomb.com I can't right now

but I can after this

guideline all right so the guideline

that I'm going to consult is C1 point

e1b this is other codes for Mera and

infection and it says when there are no

Mera combination codes code first the

condition or that illness followed by

b95.62 this is the general Mera code and

also it says do not use Z1

6.11 resistance to penicillin if the

patient has

merca all right I think this uh

eliminating something

right here the Z1

16.11 is an answer C and this can't be

correct because the patient is positive

for

imersa

also it tells you how to sequence it

says sequence first your condition

follow B Follow by

b95.62 and if we look at d d is not

sequencing properly it's sequencing the

b95.62 first followed by the condition

and that is

incorrect and some of you might say well

I'm eliminate B too but the guideline is

very

specific okay so let's not get ahead yet

not yet until we know so let's go ahead

and let's look these

up and again here's our guidance below

how to sequence when you don't have a

MCA combination

code all right so we'll begin with l01

this is cutaneous abscess Fern uncle and

carbuncle all right so we're in the

right category and if we go down it says

use additional code to identify organism

look at that additional code that's a

clue that you sequence it after this

this

code

right all right now let's go down and

look at our subcategory code

l241 cutaneous abscess of limb and then

l241 n this is cutaneous abscess of limb

unspecified indeed we don't know which

leg it was so we do have to use this

code and this is

correct

now let's go down and look at the B

95.6 Cate subcategory this is a

subcategory for staf caucus arus as the

cause of disease classified elsewhere

but you also have

b95.61 and

b95.62 what is the difference between

the

two well

b95.61 is meth Ilan