# 900 codes



## vtc76 (Oct 14, 2011)

Do ALL ICD-9-CM 900 codes require E codes?


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## minimurph97 (Nov 4, 2011)

In my experience, I would say yes.


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## mitchellde (Nov 4, 2011)

I agree I do not think I have used all or even read all of the 900 codes but every one that I have used required an E code.  Do you have a specific issue?


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## armen (Nov 4, 2011)

I dont think all of them require E code. Let say for example Dx 998.32 Disruption of external operation (surgical) wound. Why would it require E code?


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## mitchellde (Nov 4, 2011)

you need the E code to say whether this was a complication of the surgery or not due to the surgical event.


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## armen (Nov 4, 2011)

mitchellde said:


> you need the E code to say whether this was a complication of the surgery or not due to the surgical event.



the code description is already stating that it is a disruption of surgical wound.


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## mitchellde (Nov 4, 2011)

yes but there are 2 e codes for this one says it was due to a misadventure during surgery and the other says there was no misadventure during surgery, it is kind of an important issue.


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## ajs (Nov 4, 2011)

So just curious cause I never thought of it before, what E code would you use with a 900 code for either Mechanical complication of an IUD (intrauterine device) or Infection due to IUD(Intrauterine device).  I have always used the 900 codes, but never thought of looking for an E code to go with them.


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## mitchellde (Nov 4, 2011)

It would depend on the documentation can you be more specific?


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## ajs (Nov 4, 2011)

mitchellde said:


> It would depend on the documentation can you be more specific?



Here is an example that popped up in the OBGyn discussion thread:

"Pt's IUD is laying sideways in the uterine cavity and one end is embedded into the right lower endometrium. 

Diagnoses: 1. Abnormal position of intrauterine device
2. Pelvic pain, acute

Procedure: Hysteroscopy and removal of mal-positioned IUD. (Done as outpt at hosp)

This is what I want to code:
996.32 and 625.9 with procedure code 58562.

I do not want to add 58301 because I think that is accounted for in 58562. Would it hurt if I also added V25.12 as another diagnosis? "

I advised this coder to add the V25.12 to the other two codes and not to bill the 58301 as it is included in the 58562.  What do you think?


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## mitchellde (Nov 4, 2011)

Your 996.32 is for a mechanical complication of the device, meaning it malfunctioned cause the pain.. in the OCt 1 2012 guidelines the provider must state the cause and effect relationship meaning he would have say the pelvic pain is due to a malfunction of the IUD.  Your note says the IUD was malpositioned, is that a device failure? or a surgical failure?  In any event if the device failed then add the E code E878.9 to show no misadventure at the time of the procedure.  You are coding for a removal of an impacted foreign body, your note says a malpositioned IUD, therefoe you have to go with the 58301 .  I did look and did not find a CCI edit for 58555 with the 58301, please double check this and if there is none then code both.


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## mitchellde (Nov 4, 2011)

After giving it a second thought and rereading your note you did say it was embedded in the uterine wall I do agree with the use of 58562 as the procedure code and no to the 58301 sorry for any confusion there.


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## ajs (Nov 4, 2011)

mitchellde said:


> After giving it a second thought and rereading your note you did say it was embedded in the uterine wall I do agree with the use of 58562 as the procedure code and no to the 58301 sorry for any confusion there.



And I see the use for the E code in this circumstance!  I have never used E codes in OB/Gyn coding so this is very interesting!  Thanks for the lesson...it is a good day when I learn something new!


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## vtc76 (Nov 6, 2011)

Thanks for your feedback. The code I'm concerned about is 995.3 Allergy, unspecified. Does it need an E code? Most of the time, the documentation doesn't say what caused the allergy


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## mitchellde (Nov 6, 2011)

can you give all of the note concerning the the issue?  I can think of a dozen different E codes but each one for a different scenario.


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