Anesthesia Coding Alert

Now you can get more specific with a 6th digit.

Providing anesthesia for a patient with Crohn’s disease (regional enteritis) can bring potential complications from your provider’s perspective. Be sure you know how the coding options changed under ICD-10 so submitting the claims won’t bring complications of its own.

Beginning point: ICD-10 has four codes for Crohn’s disease just as ICD-9 did, based on the intestinal location.

Difference: But unlike ICD-9, you’ll need more clinical information about the patient’s condition so that you can incorporate any complications into a complete, accurate ICD-10 code.

Here’s a list of your Crohn’s code choices under ICD-9 and ICD-10:

ICD-9:

• 555.0 — Regional enteritis of small intestine 
• 555.1 — … of large intestine
• 555.2 — … of small intestine with large intestine
• 559.9 — … of unspecified site

ICD-10:

• K50.0_ — Crohn’s disease of small intestine
• K50.1_ — … of large intestine
• K50.8_ — … of both small and large intestine
• K50.9_ — … unspecified

ICD-10 expands to a fifth digit, as follows: 

• 0 — without complications
• 1 — with complications (requires 6th digit)

That’s not all: If your ICD-10 fifth digit is 1, you must add a sixth digit from the following list to avoid a truncated code:

1 — with rectal bleeding
2 — with intestinal obstruction
3 — with fistula
4 — with abscess
8 — with other complication
9 — with unspecified complications

Example: For a patient with Crohn’s identified in the large intestine with a fistula, report K50.113 as the findings.