Anesthesia Coding Alert

The Health Care Financing Administration (HCFA), like many other organizations last year, was leery of making unnecessary changes to computer-oriented materials because of possible Y2K problems. Because of this, no changes were made to the ICD-9 book. A rather long list of new codes for 2001 that incorporate changes for the past two years was first published in June 2000. These coding changes become official Oct. 1and will be mandatory for use on Jan. 1, 2001, for HCFA and some carriers. All coding professionals should become familiar with the updates to file claims accurately.

Most of the changes fall into one of three categories: lengthened codes, subcodes to an existing code or new codes.

Lengthened Codes

Many of the new codes add a fifth digit, which will help clarify ICD-9 coding. For example, codes for chronic ulcers will now be identified further by anatomical site. Before, we had only one code to use 707.9 (chronic ulcer of unspecified site), and many claims were denied because the carrier wanted the specific anatomical site, says Donna Gullikson, coding and insurance supervisor with the consulting firm Medical Computer Business Services in Augusta, Ga.

I see many other codes expanding as well.Having expanded codes will help with filing claims, she continues. It makes each diagnosis more specific, so well be able to code diagnoses more accurately. We are trained to code to the highest specificity, so being as accurate as possible is practically bred in coders. The expanded codes will definitely help us with that.

The most notable benefit of the more specific codes is better, more accurate recording of services. Practitioners need to be aware that the new codes can serve as a double-edged sword. Although, services can be recorded in more detail, claims also may be denied when nonspecific codes are used to report a diagnosis.
Claims could be denied when an old four-digit code is used to report a diagnosis instead of the appropriate new five-digit code. For example, 707.1 (ulcer of lower limbs, except decubitus) would no longer be used to report an ulcer of the heel; the more specific code 707.14 (ulcer of heel and midfoot) should be used instead.

We arent depicting a true picture of the patients condition when we use unspecified codes, Gullikson explains. The expanded codes are good to have. The more specific we can get with the code, the less time we spend working on the account and the faster payments will come in.

New Subcodes to Existing Codes

Some other codes, like failure to thrive (738.41) have been split into several related codes. Some of the expanded codes of interest to anesthesia providers include:

707.1 (ulcer of lower limbs, except decubitus). [...]