Anesthesia Coding Alert

Just as autumn is always marked by changing leaves, the beginning of new school years and baseball playoffs, in the coding world it also means implementation of new ICD-9 codes - and this year some of those changes will mean big changes for anesthesia coders. The changes to ICD-9 were first announced in May and become effective Oct. 1, 2002. Following is a rundown of what's ahead with diagnosis coding for 2003.

Many New Codes,As Always The ICD-9 updates include 147 new codes, 19 deleted codes and 23 revised codes from last year.

Although anesthesiologists usually aren't involved with assigning diagnosis codes, these codes help justify the need for anesthesia services or pain management treatment. Several new additions for 2003 will lay the foundations for more accurate anesthesia coding. One such group is the long list of new aftercare codes (V54.xx for fracture, and V58.xx for surgery), which will simplify anesthesia coding by pinpointing what kind of postoperative status the patient has, says Kelly Dennis, CPC, president of Perfect Office Solutions in Leesburg, Fla., and president of the Florida Anesthesia Administrators Association.

"We also use the tubal pregnancy codes sometimes, and these were expanded to fifth digits for more specific descriptions of with or without intrauterine pregnancy," she adds. (New codes related to abdominal, tubal, ovarian or ectopic pregnancy include 633.00-633.91.) But, as Dennis points out, using the new, more specific five-digit codes correctly depends on obtaining accurate information about the case from physicians or nurses. New codes in a related area, prematurity and newborn infant problems, will also be helpful to anesthesiologists. (There are now 10 codes for prematurity, instead of two.) By having new codes that pinpoint the exact week of gestation, carriers will better understand the increased physical status level and complications or risk factors involved in treating these infants. Several new diagnosis codes related to critical illness will help anesthesiologists in the long run. The new codes for critical illness polyneuropathy (357.82), critical illness myopathy (359.81), and SIRS (systemic inflammatory response) due to noninfectious process with organ dysfunction (995.94) each represent relatively new disease entities that are frequently seen in the ICU.

"Physicians have been writing a diagnosis of SIRS in charts for a few years, but had to find another ICD-9 code for billing purposes," says Scott Groudine, MD, an Albany, N.Y., anesthesiologist. "Now anesthesiologists can assign a better diagnosis code for some of the long-term ventilator patients they care for, and the diagnosis and billing codes can reflect each other more accurately." Most Revised Codes Deal With Heart Nineteen of the 23 revised ICD-9 codes deal with hypertensive heart disease, hypertensive heart and renal disease, heart aneurysm or congestive heart failure. These changes will help justify the need [...]