Anesthesia Coding Alert

Tip: ICD-10 combines some code choices for small intestine.

Many times, you aren’t exactly sure how you’ll report anesthesia until after the procedure when your provider knows exactly what the surgeon did. That will remain the case when your providers are involved with cases to treat colon and small intestine bleeding diverticulosis after ICD-10 becomes effective. 

ICD-9 status: Under your current coding with ICD-9, you have four diagnosis choices: 

• 562.00 (Diverticulosis of small intestine [without mention of hemorrhage])
• 562.02 (... with hemorrhage)
• 562.10 (Diverticulosis of colon [without mention of hemorrhage])
• 562.12 (... with hemorrhage).

In this scenario, because the surgeon identifies bleeding diverticulosis of both the small and large intestine, you’ll need to report both 562.02 and 562.12.

ICD-10 difference: Unlike ICD-9, in ICD-10 you’ll find a single code that describes bleeding diverticulosis for both the small intestine and colon: K57.51 (Diverticulosis of both small and large intestine without perforation or abscess with bleeding).

Another change: In addition to providing different codes based on whether the surgeon notes hemorrhage with the diverticulosis, ICD-10 also provides different codes based on whether the surgeon notes perforation or abscess. ICD-9 doesn’t include that distinction.

Watch the details: The codes listed above don’t apply to every case of diverticulosis of the colon. Both ICD-9 and ICD-10 instruct you to select different codes for the following diverticulum conditions:

• Congenital diverticulum of colon — ICD-9, 751.5 (Other congenital anomalies of intestine); ICD-10, Q43.8 (Other specified congenital malformations of intestine)
• Diverticulum of appendix — ICD-9, 543.9 (Other and unspecified diseases of appendix); ICD-10, K38.2 (Diverticulum of appendix)
• Meckel’s diverticulum — ICD-9, 751.0 (Meckel’s diverticulum); ICD-10, Q43.0 (Meckel’s diverticulum [displaced] [hypertrophic]).