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>From time to time I see ventilator dependent patients who appear to be
dysphagic secondary to the tethering effects of the trach tube on the larynx.
In my facility, I need to supply a medical diagnosis and a rehab. diagnosis
for each patient I evaluate, and each diagnosis needs an ICD-9 code.
I'm interested in learning how others are handling the medical diagnosis in
cases like this. When the patient is on a vent because of respiratory
failure, I have been listing "respiratory failure" as the medical diagnosis,
but since respiratory failure is not in and of itself the reason for the
dysphagia, it's probably only a matter of time until our Medicare
intermediary denies payment.
ICD-9 codes are used to help specify diseases and medical conditions, but
there are V codes for mechanical problems that seem as though they might help
solve my problem. I found a V code for tracheostomy, but I don't know how to
use it. Can someone explain how to use V codes? Is there a more appropriate
V code or medical condition that could be used as a medical diagnosis here?