Anesthesia Coding Alert

If you avoid ICD-9's V code section because you don't think it applies to your claims, think again. Check out the following example of when V codes can help your claims, courtesy of Emma LeGrand, CCP, CCS, coding supervisor for New Jersey Anesthesia/Health Network Management in Florham Park.

A patient with a high risk of breast cancer (because of a strong family history of breast cancer) is admitted for prophylactic organ removal of her breast. You have several main terms to choose from for diagnosis coding, so here's a step-by-step method to follow:

1. Search for the term "Admission" in the ICD-9 index.

2. Beneath the term "Admission," reference the subterm "for."

3. Follow your choices to the subterm "prophylactic."

4. Beneath "prophylactic," look for "organ removal."

5. Under "organ removal," end at "breast," which designates code V50.41 (Prophylactic organ removal; breast).

6. Look up V50.41 in ICD-9's tabular section to check for additional instructions or coding guidelines.

The surgeon and anesthesiologist can each submit their claims with V50.41 as the primary diagnosis and V16.3 (Family history of malignant neoplasm; breast) as the secondary diagnosis.

"Coders do not have to restrict themselves from using V codes," LeGrand says. "V codes provide additional information and specificity, which helps your coding and helps get your claims paid."

Caution: Carrier guidelines can differ in their use or acceptance of certain V codes, so check their policies before submitting claims.

LeGrand also recommends periodically reviewing the ICD-9-CM Official Guidelines for Coding and Reporting, which you can download from http://www.CMS.hhs.gov/ICD9 ProviderDiagnosticCodes.

"It's always good to review the basics from time to time," she says.