Anesthesia Coding Alert

Watch for 'other' versus 'unspecified' options.

When your anesthesiologist participates in an appendix surgery, you'll have more specific diagnosis code choices for appendix removal under ICD-10, effective Oct. 1, 2013.

Separate 'Other' From 'Unspecified'

Coding for acute appendicitis will change as follows, from ICD-9 to ICD-10:

• 540.0 -- Acute appendicitis with generalized peritonitis becomes K35.2 with an identical definition
• 540.1 -- Acute appendicitis with peritoneal abscess becomes K35.3 (Acute appendicitis with localized peritonitis)
• 540.9 -- Acute appendicitis without peritonitis leads to two possible ICD-10 codes: K35.80 (Unspecified acute appendicitis) or K35.89 (Other acute appendicitis).

ICD-10 introduces a similar distinction between "other" and "unspecified" for 541 (Appendicitis unqualified), which crosswalks to K37 (Unspecified appendicitis) and 542 (Other appendicitis), which crosswalks to K36 (Other appendicitis).

Find More Choices for Other Appendix Conditions

Although you'll find a one-to-one crosswalk for appendix hyperplasia (543.0, Hyperplasia of appendix [lymphoid] to K38.0, Hyperplasia of appendix), ICD-10 provides many more specific codes for other conditions.

Instead of ICD-9's catch-all code 543.9 (Other and unspecified diseases of appendix), you'll choose one of the following diagnoses under ICD-10:

• K38.1 -- Appendicular concretions
• K38.2 -- Diverticulum of appendix
• K38.3 -- Fistula of appendix
• K38.8 -- Other specified diseases of appendix
• K38.9 -- Disease of appendix, unspecified.

With all the new choices, working under ICD-10 makes checking both the anesthesia and surgical reports even more important than it is today. The more details you can extract from the reports, the more likely you'll be to choose the most appropriate diagnosis.