ICD 10 Coding Alert

Anesthesia:

Don't Shy From Asking for Surgeon's Notes When 938 Shifts to T18.9

You’ll need more details for foreign body removal under ICD-10.

It’s not unusual for you to need to check chart specifics with a surgeon’s office because your anesthesia provider didn’t get all the necessary details for coding a procedure. That can certainly be the case when the surgeon removes a foreign body from the digestive tract and the anesthesiologist doesn’t specify the site (such as stomach or colon). 

You currently have just one code choice for the situation in ICD-9, but that will change when ICD-10 becomes effective on Oct. 1, 2015. 

Current option: The correct ICD-9 code for a foreign body in an unspecified location in the digestive system is 938 (Foreign body in digestive system unspecified). ICD-9 adds these words to further describe the code: Alimentary tract NOS [not otherwise specified], or Swallowed foreign body.

ICD-10 change: When you change to ICD-10, you’ll need to use this code: T18.9 (Foreign body of alimentary tract, part unspecified), which includes the following:

  • Foreign body in digestive system NOS
  • Swallowed foreign body NOS.

Caveat: You’ll need to know more details to correctly code this condition once ICD-10 goes into effect. That’s because ICD-10 requires a seventh digit for this code, which indicates the encounter sequence for the foreign body as follows:

  • T18.9XXA — … initial encounter
  • T18.9XXD — … subsequent encounter
  • T18.9XXS — … sequela.