Overcome Anesthesia ICD-10 Diagnosis

Coding Challenges!
By Susan Dooley

Though were going on five and a half months since ICD-10 was implemented, there are still some
nuances to get used to. Fortunately, many of the diagnostic codes that anesthesia coders used with ICD9 crosswalk neatly to ICD-10.

Clear Documentation of COPD Helps Make Anesthesiologists Case

Chronic obstructive pulmonary disease, or COPD, can complicate surgeries and lead to more intensive
work for the anesthesiologist, so documenting it accurately is key for proper reimbursement.
Fortunately, not only do the ICD-9 base codes match fairly cleanly to the ICD-10 ones, but ICD-10 gives
you up to 6 digits to apply more specificity.
Here are the seven base codes for COPD in ICD-9.

490, Bronchitis, not specified as acute or chronic

491, Chronic bronchitis
492, Emphysema
493, Asthma
494, Bronchiectasis
The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
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495, Extrinsic allergic alveolitis

496, Chronic airway obstruction, not elsewhere classified.

And here are the ICD-10 versions of these base codes.

J40, Bronchitis, not specified as acute or chronic

J41, Simple and mucopurulent chronic bronchitis
J42, Unspecified chronic bronchitis
J43, Emphysema
J44, Other chronic obstructive pulmonary disease
J45, Asthma
J47, Bronchiectasis.

Watch for Specificity With ICD-10 Codes

Remember, some of these are not complete codes and require more digits to be complete. For example,
we listed J45 for Asthma, above, but to report asthma youll need documentation to determine the
severity of the symptoms.
For example, for asthma, depending on your documentation, you can choose among J45.20 (Mild
intermittent asthma, uncomplicated); J45.21 (Mild intermittent asthma with [acute] exacerbation), and
J45.22 (Mild intermittent asthma with status asthmaticus). Note that the guidelines require you to use
an additional code to identify causes of the asthma if applicable, such as exposure to environmental
tobacco smoke (Z77.22), tobacco dependence (F17.-), and others.

How About You?

If you work in anesthesia coding, have you seen major changes in your practice from the ICD-10
implementation? Let us know!

Keep Up With Changes in Coding With Anesthesia Coding Alert!

From helping you stay up to date on performance measure codes to pointing out easy-to-miss
differences in descriptors, Anesthesia Coding Alert keeps you covered. Youll uncover new anesthesia
coding opportunities to keep your practices reimbursements flowing, and you can search by code or
keyword of thousands of archived anesthesia coding articles going all the way back to 1999! to find
the info you need in a flash. Each issue touches on important ICD-10-CM training for the wide variety of
diagnoses anesthesia coders deal with each day, from Barretts esophagus to bimalleolar ankle fractures
and much, much more. Plus you get access to 24 CEUs a year to help maintain your AAPC coding
certification. Request your free sample today!

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com

Enterprise Contact Person:

Name: Sam Nair
Title: Associate Director Enterprise Practice
Email: shyamn@codinginstitute.com
Direct: 704 303 8150

Desk: 866 228 9252, Ext: 4813

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com