Anesthesia Coding Alert

Look for changes to V12, V13 and V15 series

While you-re familiarizing yourself with the new diagnosis codes, don't forget to review the V code section. The new edition includes some important changes to categories V12 (Personal history of certain other diseases), V13 (Personal history of other diseases) and V15 (Other personal history presenting hazards to health).

Most of the expanded diagnosis choices relate to the respiratory system. New options in these three series include:

- V12.42--Personal history, infections of the central nervous system

- V12.60--Personal history, unspecified disease of respiratory system

- V12.61--Personal history, pneumonia (recurrent)

- V12.69--Personal history, other diseases of respiratory system

- V13.02--Personal history, urinary (tract) infection

- V13.03--Personal history, nephrotic syndrome. -I-m excited about the -personal history of pneumonia- codes being taken out of the -personal history of other diseases of the respiratory system- section,- says Leslie Johnson, CCS-P, CPC, coding supervisor for River Oaks Imaging and Diagnostics in Houston. -There are many cases I-ve seen where this kind of frailty of the respiratory system may help the anesthesiologist determine how best to monitor the patient for respiratory distress before, during and after the case.-

Examples: Documentation of respiratory frailty might allow you to increase the patient's physical status indicator (P1-P5). Some patients also might benefit from a more progressive kind of treatment involving ventilation management after surgery to prevent pneumonia from becoming a complication to the case and to the patient.

Code V15.88 (History of fall) is another new code to check out. It won't really apply to anesthesiologists involved with surgical cases, but it could be helpful for pain management specialists. Understanding what caused a patient's problem (such as a fall or other circumstances) helps the physician determine the best course of treatment (physical therapy, medication, etc.) for a chronic pain patient.

Caution: Many insurance companies do not accept V codes for anesthesia claims, says Terry Celestino, CPC, of Tejas Anesthesia in San Antonio. Because of this, always check the carrier's guidelines regarding V codes for your claims.