Anesthesia Coding Alert

Plus: Don't miss the more specific choices for postprocedural hematoma, hemorrhage.

Most specialty coders probably are comfortable reporting all the ICD-10 changes that went into effect last October, but it's not always so easy for anesthesia coders since you need to be ready to code for any type of procedure.

With that in mind, here's a look at some vascular changes that you'll need to get details about before submitting your anesthesia provider's claims.

Artery Aneurysm and Dissection Offer More Options

ICD-10-CM now offers a couple of new options that will allow you to be more specific in your artery aneurysm coding:

• I72.5 - Aneurysm of other precerebral arteries
• I72.6 - Aneurysm of vertebral artery.

Artery dissection also has more specific choices, with the following additions to I77.7- (Other arterial dissection):

• I77.70 - Dissection of unspecified artery
• I77.75 - Dissection of other precerebral arteries
• I77.76 - Dissection of artery of upper extremity
• I77.77 - Dissection of artery of lower extremity.

And, the "other" code I77.79 has a slight change from previous years. The descriptor has shifted from "Dissection of other artery" to "Dissection of other specified artery."

You'll also find new options to report vascular stent stenosis for non-coronary vessels with the new codes listed below. Coders such as Christina Neighbors, MA, CPC, CCC, Coding Quality Auditor for Conifer Health Solutions, Coding Quality & Education Department, says these are useful changes:

• T82.856A - Stenosis of peripheral vascular stent, initial encounter
• T82.856D - Stenosis of peripheral vascular stent, subsequent encounter
• T82.856S - Stenosis of peripheral vascular stent, sequela.

The existing stenosis codes add the term "other" to make way for the additions:

• 2016: T82.858- - Stenosis of vascular prosthetic devices, implants and grafts ...
• 2017: T82.858- - Stenosis of other vascular prosthetic...

Pick Up on Subtle Postprocedural Updates

If your anesthesia provider is involved with a case involving postprocedural hemorrhage or hematoma, ICD-10 2017 includes changes for those as well. Coders now have distinct options for each condition within an organ system.

For example, note the changes to these digestive system procedure codes:

• 2016: K91.840 - Postprocedural hemorrhage and hematoma of a digestive system organ or structure following a digestive system procedure
• 2017: K91.840 - Postprocedural hemorrhage of a digestive system organ or structure following a digestive system procedure
• 2017: new code K91.870 - Postprocedural hematoma of a digestive system organ or structure following a digestive system procedure.

You'll find similar changes to provide separate codes for postprocedural hemorrhage or hematoma in the circulatory system, endocrine system, and skin and subcutaneous tissue chapters, to name a few. 

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