Anesthesia Coding Alert

Tip: Remember to include ‘personal history’ diagnosis.

Once ICD-10 goes into effect in October 2014, you’ll have to mind your Z’s and Q’s when reporting congenital heart defect diagnoses. Here are your "need to know" facts when coding patent ductus areteriosus.

Choices: ICD-9 includes a single diagnosis for the condition, 747.0 (Patent ductus arteriosus). ICD-10 also will have only one diagnosis with the same descriptor you use now. That code will be Q25.0 (Patent ductus arteriosus).

Diagnosis: With patent ductus arteriosus (PDA), abnormal blood flow occurs between the aorta and the pulmonary artery. The condition is a congenital heart defect. Codes 747.0 and Q25.0 apply to patent ductus botalli (sometime called Botallo’s) and persistent ductus arteriosus.

Documentation: Do not separately code manifestations that are an inherent component of the PDA. You may code manifestations that aren’t inherent. Work with providers to ensure you can determine which components are and aren’t inherent so your coding complies with official guidelines.

Coder tips: "If a congenital malformation or deformity has been corrected, a personal history code should be used to identify the history of the malformation or deformity," coding guidelines state. That means considering Z87.74 (Personal history of [corrected] congenital malformations of heart and circulatory system).

Remember: CMS has finalized the ICD-10 compliance date of Oct. 1, 2014, as stated in the Sept. 5, 2012, Federal Register. The announcement ended months of speculation that began in April when CMS proposed delaying the original Oct. 1, 2013, implementation date. When ICD-10-CM goes into effect, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.