General Surgery Coding Alert

That’s a change from 453.4x ICD-9 terminology.

Right now, knowing whether a lower extremity deep vein embolism or thrombosis is proximal or distal is all the information you need to fill out your claim forms. But that won’t be the case once you begin using ICD-10 in October 2014. To get ready for the change, you’ll need to train your surgeons to identify the specific vessel, if possible.

ICD-9 provides the following diagnosis codes for the condition:

·         453.40 — Acute venous embolism and thrombosis of unspecified deep vessels of lower extremity

·         453.41 — … of deep vessels of proximal lower extremity

·         453.42 — … of deep vessels of distal lower extremity.

ICD-10 Requires More

To replace the above three ICD-9 codes, you’ll need to know 32 new ICD-10 codes.

One way ICD-10 increases specificity is that you’ll need to know more precisely which vessel is involved, as follows:

·         I82.40- — Acute embolism and thrombosis of unspecified deep veins of lower extremity

·         I82.41- — … of femoral vein

·         I82.42- — … of iliac vein

·         I82.43- — … of popliteal vein

·         I82.44- — … of tibial vein

·         I82.49- — … of other specified deep vein of lower extremity

·         I82.4Y- — … of unspecified deep veins of proximal lower extremity

·         I82.4Z- — … of unspecified deep veins of distal lower extremity.

There’s more: Not stopping at eight codes, ICD-10 adds a sixth digit for each of the preceding codes, as follows, bringing the total count to 32:

·         1 right

·         2 left

·         3 bilateral

·         9 unspecified.

That means each ICD-10 code for deep vein lower extremity thrombosis or embolism will identify the specific vein, if possible, and on which side(s) the thrombosis or embolism occurs.

For example: I82.422 identifies an embolism or thrombosis of the left iliac vein.