Volume 6, Issue 3, May 2019

Medicare Risk Adjustment Coding Focus

Senile Purpura

connective tissue over time. Weakness of the lesions. Although senile purpura is not the connective tissue forces blood vessels always preventable, using sunscreen for to become fragile causing a bruising sun damage protection and wearing appearance even after a minor bump or protective clothing and hats can help to trauma, often appearing as if a serious prevent further damage to the skin2. injury has been sustained2. Coding Guidance Signs and Symptoms Senile purpura can be found in Chapter 3 Symptoms of senile purpura are large, of the ICD-10-CM codebook listed under flat, and irregularly shaped red or purple category D69, Purpura and Other Overview bruises. The spots of discoloration have hemorrhagic conditions. The ICD-10 code also been referred to as blood spots or D69.2, Other Non-thrombocytopenic Purpura refers to a hemorrhage, or skin hemorrhages. It commonly occurs on purpura, includes purpura not otherwise extravasation of blood, into the tissues or the arms, hands or top of the head as specified (NOS), purpura simplex, as well organs that appears as bruises and small these are exposed parts of the skin. It can as senile purpura2. red patches. Dependent upon size, it may also appear on mucous membranes, be referred to as petechiae or including those in the mouth, and on ecchymosis. Purpura may be associated internal organ1. Purpura and Other with thrombocytopenia, a reduction in Hemorrhagic Conditions circulating blood platelets, and can occur Other symptoms include: (HCC 48) in a non-thrombocytopenic form • Thin skin according to EncoderPro such as senile • Loose skin without elasticity D69.0 – Allergic purpura purpura4. • D69.1 – Qualitative platelet defects Easily torn skin • Occurrence of bruising without a D69.2 – Other non-thrombocytopenic Senile purpura, also known as actinic purpura related injury purpura, is an age-related condition that D69.3 – Immune thrombocytopenic purpura causes benign, easy bruising due to fragile Senile purpura bruising can last between D69.41 – Evans syndrome skin and blood vessels. Approximately 10 1 to 3 weeks before fading will occur. D69.42 – Congenital and hereditary percent of adults over the age of 50 suffer Unfortunately, the discoloration may not thrombocytopenic purpura 1 from senile purpura . However, fade completely, leaving a permanent D69.49 – Other thrombocytopenic occurrence of this skin disorder increases brown discolored appearance1. purpura with age and occurs equally among men D69.6 – Thrombocytopenia, and women. Treatment unspecified D69.8 – Other specified hemorrhagic conditions Risks & Causes Typically, treatment is not required as the D69.9 – Hemorrhagic condition, condition is benign and the body has the Aging skin is the primary cause of senile unspecified ability to self-heal. Treatment, such as a purpura as the skin becomes thin and topical retinoid, may be prescribed by a easily damaged. Extended sun exposure physician for patients who are troubled Resources: can also contribute to the development by the appearance and discoloration of of this condition as it can weaken

In New Mexico, Amerigroup Community Care of New Mexico, Inc. In Texas, Amerigroup members in the Medicaid Rural Service Area are served by Amerigroup Insurance Company; all other Amerigroup members are served by Amerigroup Texas, Inc. In Washington, Amerigroup Washington, Inc. Amerivantage is a DSNP plan with a Medicare contract and a contract with the State Medicaid program. In New Mexico: Amerivantage is an HMO with a Medicare contract. Enrollment in Amerivantage depends on contract renewal.

AGPCARE -0128-19Y0114_19_107957_I_05/29/2019 . Volume 6, Issue 3, May 2019

1 Johnson, J. (n.d.). Senile purpura: Causes, 2 Schmidt, A. & Patterson, L. (2018). ICD-10- 4Purpura and other hemorrhagic conditions. symptoms, and diagnosis. Retrieved from CM Expert for Physicians. Optum Insight Inc. (n.d.). Retrieved from encoderpro.com medicalnewstoday.com

In New Mexico, Amerigroup Community Care of New Mexico, Inc. In Texas, Amerigroup members in the Medicaid Rural Service Area are served by Amerigroup Insurance Company; all other Amerigroup members are served by Amerigroup Texas, Inc. In Washington, Amerigroup Washington, Inc. Amerivantage is a DSNP plan with a Medicare contract and a contract with the State Medicaid program. In New Mexico: Amerivantage is an HMO with a Medicare contract. Enrollment in Amerivantage depends on contract renewal.

AGPCARE -0128-19Y0114_19_107957_I_05/29/2019 .