Anesthesia Coding Alert

Most carriers pay claims based on CPT Codes , so ICD-9 Diagnosis Codes seem less important in many cases (especially for specialties such as anesthesia) than the procedure codes themselves. So why are they still important to anesthesia providers?

First, having detailed diagnosis codes helps support the use of anesthesia in some cases. For example, modifier -G9 (Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition) can only be used for patients with particular diagnoses, such as malignant hypertension (401.0), cardiomyopathy (425.0-425.9), life-threatening arrhythmias (426.0-427.69) or heart failure (428.0-428.9). Second, pain management physicians can use ICD-9 codes to help justify their services for patients with conditions such as reflex sympathetic dystrophy (337.20-337.29), sciatica (724.3), neuritis or secondary to lumbar intervertebral disk disease (722.10 ), or lesion in the nerve itself (355.0), and nerve entrapment such as carpal tunnel syndrome (354.0).

The Internet has a wealth of information about ICD-9 and the changes for 2003. Two sites with details are:

Centers for Medicare and Medicaid Services (CMS) at http://www.cms.hhs.gov/medlearn/icd9code.asp
National Center for Health Statistics (NCHS) at www.cdc.gov/nchs/