Anesthesia Cross Coder Essential links from CPT codes to ICD-9-CM and HCPCS codes
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... 37 Neck... 121 Thorax (Chest Wall and Shoulder Girdle)... 151 Intrathoracic... 170 Spine and Spinal Cord... 211 Upper Abdomen... 231 Lower Abdomen... 257 Perineum... 304 Pelvis (Except Hip)...339 Upper Leg (Except Knee)...348 Knee and Popliteal Area...366 Lower Leg (Below Knee, Includes Ankle and Foot)...387 Shoulder and Axilla...405 Upper Arm and Elbow...418 Forearm, Wrist, and Hand...431 Radiological Procedures...454 Burn Excisions or Debridement...473 Obstetric...480 Other Procedures...489 Introduction/Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic...490 Moderate (Conscious) Sedation...497 Appendixes Modifiers... 499 Glossary... 501 Crosswalks 2009 Ingenix, Inc. CPT 2009 American Medical Association. All Rights Reserved. 1
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 00100 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
CPT Procedure to Anesthesia Code 0016T 0017T 0048T 0050T 0051T 0052T 0053T 0071T 0072T 0073T 01922 0075T 00350 01925 0078T 00770 01926 0080T 01925 0099T 0100T 0102T 01730 0123T 00147 0124T 0141T 0142T 0143T 00770 0155T 0156T 0157T 0158T 0166T 0167T 00561 00562 00563 0169T 00214 0171T 00670 0177T 0184T 00902 0195T 00670 0200T 01936 0201T 01936 0202T 0205T 0207T 0217T 00600 0218T 00620 0219T 00600 0220T 00620 0221T 10060 10061 10080 10081 10120 10121 10140 10160 10180 11000 11004 11005 00800 11006 11010 11011 00730 01250 01320 01470 01610 01710 01810 11012 00190 00450 00470 01120 01230 01360 01392 01400 01480 01630 01740 01830 11040 11041 11042 11043 01250 01320 01470 01610 01710 01810 11044 00160 00190 00450 00470 01120 01210 01230 01360 01392 01400 01480 01630 01740 01742 01830 11055 11056 11057 11100 11200 11300 11301 11302 11303 11305 11306 11307 11308 11310 11311 11312 11313 11400 11401 11402 11403 11404 11406 11420 11421 11422 11423 11424 11426 11440 11441 11442 11443 11444 11446 11450 11451 11462 11463 11470 11471 11600 11601 11602 11603 11604 11606 11620 1 2009 Ingenix, Inc. CPT only 2009 American Medical Association. All Rights Reserved.
00866 00866 00866 Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy Associated CPT Codes 60540 Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); 60545 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 60650 Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal ICD-9-CM Diagnostic 189.0 Malignant neoplasm of kidney, except pelvis 189.1 Malignant neoplasm of renal pelvis 194.0 Malignant neoplasm of adrenal gland 197.6 Secondary malignant neoplasm of retroperitoneum and peritoneum 197.7 Secondary malignant neoplasm of liver 198.7 Secondary malignant neoplasm of adrenal gland 211.8 Benign neoplasm of retroperitoneum and peritoneum 227.0 Benign neoplasm of adrenal gland (Use additional code to identify any functional activity) 234.8 Carcinoma in situ of other specified sites 235.4 Neoplasm of uncertain behavior of retroperitoneum and peritoneum 237.2 Neoplasm of uncertain behavior of adrenal gland (Use additional code to identify any functional activity) 239.0 Neoplasm of unspecified nature of digestive system 239.7 Neoplasm of unspecified nature of endocrine glands and other parts of nervous system 255.0 Cushing's syndrome (Use additional E code to identify cause, if drug-induced) 255.10 Hyperaldosteronism, unspecified 2 255.11 Glucocorticoid-remediable aldosteronism 255.12 Conn's syndrome 255.13 Bartter's syndrome 255.14 Other secondary aldosteronism 255.2 Adrenogenital disorders 255.3 Other corticoadrenal overactivity 255.41 Glucocorticoid deficiency 255.42 Mineralocorticoid deficiency 255.5 Other adrenal hypofunction 255.6 Medulloadrenal hyperfunction V64.41 Laparoscopic surgical procedure converted to open procedure ICD-9-CM Procedural 07.00 Exploration of adrenal field, not otherwise specified 07.01 Unilateral exploration of adrenal field 07.02 Bilateral exploration of adrenal field 07.12 Open biopsy of adrenal gland 07.22 Unilateral adrenalectomy 07.29 Other partial adrenalectomy 07.3 Bilateral adrenalectomy 17.41 Open robotic assisted procedure 17.42 Laparoscopic robotic assisted procedure 17.43 Percutaneous robotic assisted procedure 17.44 Endoscopic robotic assisted procedure 17.49 Other and unspecified robotic assisted procedure 54.4 Excision or destruction of peritoneal tissue 00868 00868 Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient) Associated CPT Codes 50360 Renal allotransplantation, implantation of graft; without recipient nephrectomy 50365 Renal allotransplantation, implantation of graft; with recipient nephrectomy 50380 Renal autotransplantation, reimplantation of kidney Anesthesia Cross Coder ICD-9-CM Diagnostic 189.0 Malignant neoplasm of kidney, except pelvis 189.1 Malignant neoplasm of renal pelvis 198.0 Secondary malignant neoplasm of kidney 223.0 Benign neoplasm of kidney, except pelvis 236.91 Neoplasm of uncertain behavior of kidney and ureter 249.40 Secondary diabetes mellitus with renal manifestations, not stated as uncontrolled, or unspecified (Use additional code to identify manifestation: 581.81, 583.81, 585.1-585.9) (Use additional code to identify any associated insulin use: V58.67) 249.41 Secondary diabetes mellitus with renal manifestations, uncontrolled (Use additional code to identify manifestation: 581.81, 583.81, 585.1-585.9) (Use additional code to identify any associated insulin use: V58.67) 250.40 Diabetes with renal manifestations, type II or unspecified type, not stated as uncontrolled (Use additional code to identify manifestation: 581.81, 583.81, 585.1-585.9) 250.41 Diabetes with renal manifestations, type I [juvenile type], not stated as uncontrolled (Use additional code to identify manifestation: 581.81, 583.81, 585.1-585.9) 250.42 Diabetes with renal manifestations, type II or unspecified type, uncontrolled (Use additional code to identify manifestation: 581.81, 583.81, 585.1-585.9) 250.43 Diabetes with renal manifestations, type I [juvenile type], uncontrolled (Use additional code to identify manifestation: 581.81, 583.81, 585.1-585.9) 403.01 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) 403.11 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) 403.91 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) 2 405.01 Secondary renovascular hypertension, malignant 405.11 Secondary renovascular hypertension, benign 445.81 Atheroembolism of kidney (Use additional code for any associated acute kidney failure or chronic kidney disease: 584, 585) 580.0 Acute glomerulonephritis with lesion of proliferative glomerulonephritis 581.0 Nephrotic syndrome with lesion of proliferative glomerulonephritis 581.81 Nephrotic syndrome with other specified pathological lesion in kidney in diseases classified elsewhere (Code first underlying disease: 084.9, 249.4, 250.4, 277.30-277.39, 446.0, 710.0) E 582.0 Chronic glomerulonephritis with lesion of proliferative glomerulonephritis 583.81 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, 098.19, 249.4, 250.4, 277.30-277.39, 446.21, 710.0) E 584.5 Acute kidney failure with lesion of tubular necrosis 585.1 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, 420.0. Code first hypertensive chronic kidney disease, if applicable: 403.00-403.91, 404.00-404.93) 585.2 Chronic kidney disease, Stage II (mild) (Use additional code to identify kidney 585.3 Chronic kidney disease, Stage III (moderate) (Use additional code to identify kidney 585.4 Chronic kidney disease, Stage IV (severe) (Use additional code to identify kidney 585.5 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, 420.0. Code first hypertensive chronic kidney disease, if applicable: 403.00-403.91, 404.00-404.93) 585.6 End stage renal disease (Use additional code to identify kidney transplant status, if applicable: V42.0. Use additional code to identify manifestation: 357.4, 420.0. Code first hypertensive chronic kidney disease, if applicable: 300 2 Unspecified code ; Female diagnosis E Manifestation code : Male diagnosis 2009 Ingenix, Inc. CPT only 2009 American Medical Association. All Rights Reserved.