General Surgery Coding Alert

Exclusions vary slightly for new diagnosis code set.

Unlike many conditions, you won't need to change the way you document peritoneal adhesions when you switch to ICD-10. That's because the new code for the condition has a one-to-one correspondence with the old code when you finally switch from ICD-9.

Don't forget: CMS has announced a proposed implementation date change from Oct. 1, 2013 to Oct. 1, 2014 for the new diagnosis code set.

Female Pelvis and Gastrointestinal Don't Count

ICD-9's 568.0 (Peritoneal adhesions [postoperative] [postinfection]) will become K66.0 (Peritoneal adhesions [postprocedural] [postinfection]) when the new code set goes into effect.

Both code sets agree on the description of the condition as "adhesions (of)" the following sites:

• abdominal (wall)
• diaphragm
• intestine
• male pelvis
• mesenteric
• omentum
• stomach

Watch exclusions: ICD-9 and ICD-10 exclude similar conditions and direct the coder to appropriate codes.

For 568.0, the excludes note lists adhesions of

• pelvic, female (614.6)
• with obstruction:

duodenum (537.3)
intestine (560.81)

For K66.0, you'll find a similar excludes list:

• female pelvic adhesions [bands] (N73.6)
• peritoneal adhesions with intestinal obstruction (K56.5)

Look for 'NEC' Code

One difference for reporting pelvic adhesions in ICD-10 instead of ICD-9 is the addition of a "not elsewhere classified" code, N99.4 (Postprocedural pelvic peritoneal adhesions).

ICD-10 states that N99.4 excludes

• pelvic peritoneal adhesions NOS (N73.6)
• postinfective pelvic peritoneal adhesions (N73.6)