Anesthesia Cross Coder. Essential links from CPT codes to ICD-9-CM and HCPCS codes

Transcription

1 Anesthesia Cross Coder Essential links from CPT codes to ICD-9-CM and HCPCS codes

2 Contents Introduction... i CPT Anesthesia to Procedure Crosswalk...i Format...i Icon Key...ii CPT Codes...ii Code Links...iii ICD-9-CM Diagnostic Codes...iii ICD-9-CM Procedural Codes...iv HCPCS Level II Codes...iv Modifiers...iv Summary...iv CPT Procedure to Anesthesia Code... 1 Head Neck Thorax (Chest Wall and Shoulder Girdle) Intrathoracic Spine and Spinal Cord Upper Abdomen Lower Abdomen Perineum Pelvis (Except Hip) Upper Leg (Except Knee) Knee and Popliteal Area Lower Leg (Below Knee, Includes Ankle and Foot) Shoulder and Axilla Upper Arm and Elbow Forearm, Wrist, and Hand Radiological Procedures Burn Excisions or Debridement Obstetric Other Procedures Introduction/Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Moderate (Conscious) Sedation Appendixes Modifiers Glossary Crosswalks 2009 Ingenix, Inc. CPT 2009 American Medical Association. All Rights Reserved. 1

3 Introduction Ingenix is pleased to present the 2010 Anesthesia Cross Coder. Fully comprehensive, the Anesthesia Cross Coder links more than 300 CPT codes commonly used by anesthesiologists to corresponding surgical CPT and ICD-9-CM diagnosis codes, and as appropriate, ICD-9-CM procedure and HCPCS Level II codes. Ingenix believes that professional coders working in physician offices, clinical outpatient areas, hospitals, as well as payer settings will find this reference a useful tool. Anesthesia Cross Coder is based on the Anesthesia section of Physicians Current Procedural Terminology (CPT ), but includes CPT codes commonly used by practicing anesthesiologists from other sections of the CPT system as well. Up-to-date CPT codes link to the following related medical coding systems: International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) Healthcare Common Procedural Coding System (HCPCS) Level II All coding relationships in Anesthesia Cross Coder start with the Anesthesia section of the CPT book presenting a general clinical picture of each anesthesia code. Pertinent surgical related coding relationships were carfully reviewed and screened for appropriate information. In some instances, the data is abridged simply due to the enormity of the listings. For example, diagnosis codes for infections call for additional codes to identify specific organisms. The possible associations are too numerous and do not appear in Anesthesia Cross Coder. In a similar vein, Anesthesia Cross Coder features codes that require accompanying etiologies or manifestations (e.g., Code first underlying disease ). However, associated infectious and parasitic diseases are, once again, simply too numerous to list and do not appear in Anesthesia Cross Coder. For further discussion on secondary diagnosis codes, see the ICD-9-CM section later in this introduction. Some CPT codes are omitted from the listing because consistent and reliable cross-links are almost impossible to establish. Unlisted procedure codes are an obvious example. As a coding reference, Anesthesia Cross Coder presents most likely scenarios as derived from clinical information sources. Anesthesia Cross Coder is not a substitute for ICD-9-CM or any other medical coding reference and users are urged to regularly consult all available sources. The absence of any specific code does not necessarily indicate that its association to the base procedure code is inappropriate. Assuming all rules of anesthesia coding are followed, excepted diagnosis codes may prove appropriate to a specific code scenario. Anesthesia Cross Coder does not include coding rules or guidelines. Once again, the user is urged to consult the original coding reference (e.g., CPT, ICD-9-CM, HCPCS Level II, etc.) or one of several reputable medical coding instruction manuals. CPT Anesthesia to Procedure Code Crosswalk The surgical CPT codes are listed with the corresponding anesthesia CPT codes. The relationships were developed by comparing each individual surgical CPT code, current practice patterns, and techniques to determine the appropriate relationship of the surgical code to the anesthesia CPT code assignment. Using this methodology, the surgical codes and anesthesia codes are assigned the most appropriate coding relationships. Ingenix does not rely on the combinations suggested by other organizations or groups with the exception of CMS. Reimbursement data was not used to suggest one code combination over another. Format An understanding of the Anesthesia Cross Coder format allows users to easily navigate its content. Information within the main section ties to the CPT book and the codes are presented in the same numeric order as the anesthesia and other appropriate CPT sections. Sections Anesthesia Cross Coder provides linked information to the CPT code range to 01999, as well as several other code ranges typically used by anesthesiologists. The codes are divided into the same sections as found in the CPT book. Codes and Code Ranges The data within each CPT codeset of Anesthesia Cross Coder is presented as follows: Anesthesia CPT code Corresponding surgical CPT codes and descriptions ICD-9-CM diagnostic codes and descriptions ICD-9-CM procedural codes and descriptions, where applicable HCPCS Level II codes and descriptions, where applicable Crosswalks 2009 Ingenix, Inc. CPT 2009 American Medical Association. All Rights Reserved. i

4 CPT Procedure to Anesthesia Code 0016T 0017T 0048T 0050T 0051T 0052T 0053T 0071T 0072T 0073T T T T T 0100T 0102T T T 0141T 0142T 0143T T 0156T 0157T 0158T 0166T 0167T T T T 0184T T T T T 0205T 0207T 0217T T T T T Ingenix, Inc. CPT only 2009 American Medical Association. All Rights Reserved.

5 Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy Associated CPT Codes Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal ICD-9-CM Diagnostic Malignant neoplasm of kidney, except pelvis Malignant neoplasm of renal pelvis Malignant neoplasm of adrenal gland Secondary malignant neoplasm of retroperitoneum and peritoneum Secondary malignant neoplasm of liver Secondary malignant neoplasm of adrenal gland Benign neoplasm of retroperitoneum and peritoneum Benign neoplasm of adrenal gland (Use additional code to identify any functional activity) Carcinoma in situ of other specified sites Neoplasm of uncertain behavior of retroperitoneum and peritoneum Neoplasm of uncertain behavior of adrenal gland (Use additional code to identify any functional activity) Neoplasm of unspecified nature of digestive system Neoplasm of unspecified nature of endocrine glands and other parts of nervous system Cushing's syndrome (Use additional E code to identify cause, if drug-induced) Hyperaldosteronism, unspecified Glucocorticoid-remediable aldosteronism Conn's syndrome Bartter's syndrome Other secondary aldosteronism Adrenogenital disorders Other corticoadrenal overactivity Glucocorticoid deficiency Mineralocorticoid deficiency Other adrenal hypofunction Medulloadrenal hyperfunction V64.41 Laparoscopic surgical procedure converted to open procedure ICD-9-CM Procedural Exploration of adrenal field, not otherwise specified Unilateral exploration of adrenal field Bilateral exploration of adrenal field Open biopsy of adrenal gland Unilateral adrenalectomy Other partial adrenalectomy 07.3 Bilateral adrenalectomy Open robotic assisted procedure Laparoscopic robotic assisted procedure Percutaneous robotic assisted procedure Endoscopic robotic assisted procedure Other and unspecified robotic assisted procedure 54.4 Excision or destruction of peritoneal tissue Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient) Associated CPT Codes Renal allotransplantation, implantation of graft; without recipient nephrectomy Renal allotransplantation, implantation of graft; with recipient nephrectomy Renal autotransplantation, reimplantation of kidney Anesthesia Cross Coder ICD-9-CM Diagnostic Malignant neoplasm of kidney, except pelvis Malignant neoplasm of renal pelvis Secondary malignant neoplasm of kidney Benign neoplasm of kidney, except pelvis Neoplasm of uncertain behavior of kidney and ureter Secondary diabetes mellitus with renal manifestations, not stated as uncontrolled, or unspecified (Use additional code to identify manifestation: , , ) (Use additional code to identify any associated insulin use: V58.67) Secondary diabetes mellitus with renal manifestations, uncontrolled (Use additional code to identify manifestation: , , ) (Use additional code to identify any associated insulin use: V58.67) Diabetes with renal manifestations, type II or unspecified type, not stated as uncontrolled (Use additional code to identify manifestation: , , ) Diabetes with renal manifestations, type I [juvenile type], not stated as uncontrolled (Use additional code to identify manifestation: , , ) Diabetes with renal manifestations, type II or unspecified type, uncontrolled (Use additional code to identify manifestation: , , ) Diabetes with renal manifestations, type I [juvenile type], uncontrolled (Use additional code to identify manifestation: , , ) Hypertensive chronic kidney disease, malignant, with chronic kidney disease stage V or end stage renal disease (Use additional code to identify the stage of chronic kidney disease: 585.5, 585.6) Hypertensive chronic kidney disease, benign, with chronic kidney disease stage V or end stage renal disease (Use additional code to identify the stage of chronic kidney disease: 585.5, 585.6) Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease (Use additional code to identify the stage of chronic kidney disease: 585.5, 585.6) Secondary renovascular hypertension, malignant Secondary renovascular hypertension, benign Atheroembolism of kidney (Use additional code for any associated acute kidney failure or chronic kidney disease: 584, 585) Acute glomerulonephritis with lesion of proliferative glomerulonephritis Nephrotic syndrome with lesion of proliferative glomerulonephritis Nephrotic syndrome with other specified pathological lesion in kidney in diseases classified elsewhere (Code first underlying disease: 084.9, 249.4, 250.4, , 446.0, 710.0) E Chronic glomerulonephritis with lesion of proliferative glomerulonephritis Nephritis and nephropathy, not specified as acute or chronic, with other specified pathological lesion in kidney, in diseases classified elsewhere (Code first underlying disease: 016.0, , 249.4, 250.4, , , 710.0) E Acute kidney failure with lesion of tubular necrosis Chronic kidney disease, Stage I (Use additional code to identify kidney transplant status, if applicable: V42.0. Use additional code to identify manifestation: 357.4, Code first hypertensive chronic kidney disease, if applicable: , ) Chronic kidney disease, Stage II (mild) (Use additional code to identify kidney Chronic kidney disease, Stage III (moderate) (Use additional code to identify kidney Chronic kidney disease, Stage IV (severe) (Use additional code to identify kidney Chronic kidney disease, Stage V (Use additional code to identify kidney transplant status, if applicable: V42.0. Use additional code to identify manifestation: 357.4, Code first hypertensive chronic kidney disease, if applicable: , ) End stage renal disease (Use additional code to identify kidney transplant status, if applicable: V42.0. Use additional code to identify manifestation: 357.4, Code first hypertensive chronic kidney disease, if applicable: Unspecified code ; Female diagnosis E Manifestation code : Male diagnosis 2009 Ingenix, Inc. CPT only 2009 American Medical Association. All Rights Reserved.