Anesthesia Coding Alert

You’ll move from two diagnosis options to five.

Underlying conditions can make a difference in how your anesthesia provider cares for a patient, so being aware of circumstances helps during the procedure and when you code the claim. One example is emphysema, which will double its diagnosis choices when ICD-10 becomes effective in October.

ICD-9 coding: Today, when you report emphysema, you use an ICD-9 code from the 492 (Emphysema) family. You include a fourth digit to represent the type of emphysema as follows:

• 492.0 (Emphysematous bleb) — This type includes a diagnosis of giant bullous emphysema, ruptured emphysematous bleb, tension pneumatocele, and vanishing lung.

• 492.8 (Other emphysema) — includes a diagnosis of emphysema (lung or pulmonary), MacLeod’s syndrome, Swyer-James syndrome, and unilateral hyperlucent lung.

ICD-10 shift: When you start reporting ICD-10 codes, you’ll turn to group J43 (Emphysema). Your current option of 492.0 will be a direct match to new diagnosis J43.9 (Emphysema, unspecified). If you need a match to 492.8, however, you’ll choose between four additional codes that describe the type of emphysema formerly included in 492.8:

• J43.0 — Unilateral pulmonary emphysema [MacLeod’s syndrome]

• J43.1 — Panlobular emphysema

• J43.2 — Centrilobular emphysema

• J43.8 — Other emphysema.

Good news: Your physician is likely already documenting the details you’ll need to choose the right code (or you should at least be able to get the information from the surgeon). But if he isn’t, be sure to explain that accurate ICD-10 coding will require very specific details and encourage him to start providing you as much information as possible in his notes.