Anesthesia Coding Alert

Heads up: You’ll need to know more than the location, beginning in October. 

Patients who are treated for ulcerative colitis can experience a range of complications, including rectal bleeding, internal obstruction, and more. Once ICD-10 goes into effect on Oct. 1, you’ll need to pay closer attention to these complications – and prepare to ask for the surgeon’s op report when necessary – to accurately code your anesthesia provider’s service. 

Learn the No-Complication Crosswalks

Without considering complications, you can see from the following list that the crosswalk from ICD-9 to ICD-10 is fairly straightforward for ulcerative colitis:

• 556.3 (Ulcerative [chronic] proctosigmoiditis) to K51.30 (Ulcerative [chronic] rectosigmoiditis without complications)
• 556.4 (Pseudopolyposis of colon) to  K51.40 (Inflammatory polyps of colon without complications)
• 556.5 (Left-sided ulcerative [chronic] colitis) to : K51.50 (Left sided colitis without complications)
• 556.6 (Universal ulcerative [chronic] colitis) to K51.00 (Ulcerative [chronic] pancolitis without complications)
• 556.8 (Other ulcerative colitis) or 556.0 (Ulcerative [chronic] enterocolitis) or 556.1 (Ulcerative [chronic] ileocolitis) to K51.80 (Other ulcerative colitis without complications) 
• 556.9 (Ulcerative colitis unspecified) to K51.90 (Ulcerative colitis, unspecified, without complications).

Complications Will Multiply Your Choices

You won’t get the whole story for ICD-10 ulcerative colitis coding until you learn the fifth and sixth digit options. For each code, a fifth digit of 1 instead of 0 indicates the same condition, except with complications. Then you need to know the sixth digit designations, which report specific complications as follows:

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

For instance: Under ICD-9, you would report universal ulcerative colitis with rectal bleeding as 556.6. But the same condition under ICD-10 becomes K51.011 (Ulcerative [chronic] pancolitis with rectal bleeding).