Wiki ICD-9 procedure coding


True Blue
Holts Summit, MO
Best answers
If this is outpatient facility you do not use the ICD-9 Volume 3 codes, if this is inpatient you do not use CPT codes. You never use both sets on the same claim it is one or the other.
If you code both it is probably an IT issue with your grouper. But if the coding dept puts the Vol3 codes on then someone in billing must remove them before the claim drops or the claim will deny. If you use the 3M encoder then when you first bring it up check the grouper, if it is set to DRG then the system will force you to code the ICD-9 Vol 3 codes but if the option has been "turned on" you should be able to change your grouper to the APC version and the Vol 3 codes do not even come up.
I would speak to someone if you can because it is unnecessary work on your part to assign them creating unnecessary work elsewhere to remove them.
If there is no way to change this in your department then rest assured it truely does not matter on the Vol3 codes as they are nonsensical for outpatient.
Your facility is likely using Vol III for its surgical or procedural registry; thus, some level of accuracy is demanded. Personally, I have advised hospitals for years to convert their registries over the CPT, as some very large US hospitals have done; with ICD-10, my suggestion is moot. Though I agree it is superfluous, there is little you can do. I have regularly seen hospital bills produced (paper primarily) with both sets of codes, but no DRG for the OP bill type.

To respond directly to your question, if you must code in both, CPT bundling rules do not impact the code assignment in ICD-9 Vol III. In other words, you cannot (ever) apply the rules in one coding system to another coding system; they are distinct and unrelated--hence, why crosswalks are so very inaccurate, they do not account for variances in coding guidelines. You would probably need to code the procedures separately in ICD-9 Vol III, though I do not have my manual here with me as I respond to this.