General Surgery Coding Alert

The July article in General Surgery Coding Alert, Gain Reimbursement for the Revision of AV Fistulas and Subsequent Thrombectomies, stated that the primary diagnosis code for thrombectomy and/or revision of an AV fistula should be 996.1 (mechanical complication of other vascular device, implant and graft). A more precise code, 996.73 (other complications due to renal dialysis device, implant and graft), is more appropriate, because the failure of the fistula requiring revision/thrombectomy may not due to mechanical reasons.

In a June article, Signs/Symptoms Codes Increase Pay Up and Safeguard Patients, on page 50, the incorrect ICD-9 code was used to describe a malignant neoplasm of the skin. General Surgery Coding Alert used 239.2 (neoplasm of unspecified nature; bone, soft tissue and skin). It would have been more accurate to use 172.x (malignant melanoma of skin) or 173.x (other malignant neoplasm of skin).