General Surgery Coding Alert
Inguinal Hernia Dx Still Depends on Obstruction, Gangrene, and More
Watch tricky hierarchy switch from ICD-9 to ICD-10. You'll have the same number of code choices and the same diagnostic distinctions for coding inguinal hernias when ICD-9 becomes ICD-10 in 2013. But elevating the bilateral/unilateral distinction from the fifth digit in ICD-9 to the fourth digit in ICD-10 confounds the one-to-one code correspondence. ICD-9 Prioritizes Gangrene, Obstruction ICD-9 lists three, four-digit codes for inguinal hernia: 550.0 -- Inguinal hernia with gangrene 550.1 -- Inguinal hernia, with obstruction, without mention of gangrene 550.9 -- Inguinal hernia, without mention of obstruction or gangrene. You should append a fifth digit to each of these codes to distinguish bilateral/unilateral and recurrent or not, as follows: 0 -- unilateral or unspecified (not specified as recurrent) 1 -- unilateral or unspecified, recurrent 2 -- bilateral (not specified as recurrent) 3 -- bilateral, recurrent. ICD-10 Prioritizes Gangrene, Obstruction, and Unilateral/Bilateral ICD-10 lists six, four digit codes for inguinal hernia: K40.0 -- Bilateral inguinal hernia, with obstruction, without gangrene K40.1 -- Bilateral inguinal hernia, with gangrene K40.2 -- Bilateral inguinal hernia, without obstruction or gangrene K40.3 -- Unilateral inguinal hernia, with obstruction, without gangrene K40.4 -- Unilateral inguinal hernia, with gangrene K40.9 -- Unilateral inguinal hernia, without obstruction or gangrene. You should append a fifth digit to each of these codes to distinguish recurrent or not as follows: 0 -- not specified as recurrent 1 -- recurrent. Put Them Together for 12 Codes Because of the hierarchy difference, you can't find a direct correspondence for the four-digit codes. For instance, 550.0 could be K40.1 or K40.4. Crosswalk: 550.00 - K40.40 550.01 - K40.41 550.02 - K40.10 550.03 - K40.11 550.10 - K40.30 550.11 - K40.31 550.12 - K40.00 550.13 - K40.01 550.90 - K40.90 550.91 - K40.91 550.92 - K40.20 550.93 - K40.21
General Surgery Coding Alert
- CCI 17.1:
49491-49580: Include 'Usual and Necessary' Services in Hernia Repair
'Standards of surgical practice' lead edit pairs for many procedures.Infusions, punctures, blocks, heart/lung monitoring, radiology [...] - ICD-10:
Inguinal Hernia Dx Still Depends on Obstruction, Gangrene, and More
Watch tricky hierarchy switch from ICD-9 to ICD-10.You'll have the same number of code choices [...] - CPT 2011:
37228-+37235: 4 Steps Garner TP Trunk Services Pay
Make sure you identify initial and additional vessel procedures. With a new section for endovascular [...] - Practice Management:
Distinguish Facility's Documentation Rules From Surgeon's Report
Concentrate on your physician's thorough note. Myth: When your surgeon performs surgery in a hospital, [...] - You Be the Coder:
E/M: Service Drives Critical Care
Question:After a patient with chest pain "coded" in the ER and was admitted to ICU, [...] - Reader Questions:
Separate Office Visit/Hospital Admissions -- Sometimes
Question:Our physician saw a patient in the office, then admitted her to the hospital later [...] - Reader Questions:
Update Your 2011 CPT Modifier Choices
Question:We read lots of information about CPT 2011 code changes, but are there any modifier [...] - Reader Questions:
24200, 23330: Anatomy Solves FBR Denial
Question:Our surgeon used a scalpel and tweezers to perform complicated splinter removal on a patient's [...]
