General Surgery Coding Alert
ICD-9 Update:
Prepare Now for Revisions in the New Year Although the New Year is still months away, some payers will begin to implement revised ICD-9 guidelines for 2003 as early as Oct. 1, 2002. Proposed revisions to ICD-9, initially announced in the May 9, 2002, Federal Register (Vol. 67, No. 90, pp. 31627-31631), include nearly 150 new diagnosis codes, as well as 19 code deletions. All payers must accommodate the changes on or before Jan. 1, 2003. Many new codes reflect a trend toward greater diagnosis specificity. For example, five codes (459.30, 459.31, 459.32, 459.33 and 459.39) have been added to describe chronic venous hypertension without complications, with ulcer, with inflammation, with ulcer and inflammation, or with other complication. The largest category of new codes focuses on pediatric and obstetric diagnoses. For example, there are now 10 codes, 633.00-633.91, to describe various abdominal, tubal, ovarian and ectopic pregnancies. New codes of particular interest to general surgery practice include: The approximately 150 code additions to ICD-9 for 2003 also include 40 new V codes, of which 31 are "aftercare" codes for patient care following surgery, e.g., V58.43, Aftercare following surgery for injury and trauma. Payer response to the new codes is as yet uncertain. Other codes in this category that general surgeons may use include: Codes 459.1 (Postphlebitic syndrome) and 998.3 (Disruption of operation wound) have been eliminated from ICD-9, replaced by the more specific five-digit code categories listed above, 459.1x and 998.3x. The remaining 16 deletions follow the same pattern. Twenty-three codes will receive revised descriptors for 2003. Of these, 15 involve categories 402.00-402.91 and 404.00-404.93 to describe hypertensive heart disease and hypertensive heart and renal disease, respectively which surgeons will occasionally access. The changes include minor text revisions that will not affect how the codes are applied. Note: For a complete list of additions, deletions and revisions to ICD-9 for 2003, visit the Federal Register at the Government Printing Office World Wide Web site: www.access.gpo.gov/su_docs/aces/aces140.html.
General Surgery Coding Alert
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Post-Op Debridement
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Prepare Now for Revisions in the New Year Although the New Year is still months [...] - Reader Question:
Time-Based Consult
Question: Our surgeon spent 85 minutes providing a consultation for a patient in the hospital. [...] - Reader Question:
Reporting Hyperalimentation
Question: What is the appropriate code to report hyperalimentation or TPN? The only code I [...] - Reader Question:
Discontinued Surgery
Question: During a recent surgery, the patient developed uncontrolled bleeding, and the surgeon had to [...] - Statement of Ownership, Management, and Circulation
