Anesthesia Coding Alert

Hint: You’ll need to pay even closer attention to the surgeon’s record.

The long-awaited ICD-10 update is coming in October, with plenty of changes you’ll need to be aware of from an anesthesia perspective. The vascular system in particular will include several important shifts that will have you gathering every detail possible from the surgeon’s report. Read on for some highlights to three vascular areas.

Area 1: Artery Aneurysm and Dissection

 ICD-10-CM will likely offer 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 will probably see more specific options in October, as well, 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.

You also can expect a revision to “other” code I77.79:

• 2016: I77.79 — Dissection of other artery
• 2017: I77.79 — Dissection of other specified artery.

Area 2: Vascular Stent Stenosis

You can also anticipate new options to report vascular stent stenosis for non-coronary vessels with the new codes listed below. “This should be a useful addition,” says Christina Neighbors, MA, CPC, CCC, Coding Quality Auditor for Conifer Health Solutions, Coding Quality & Education Department.

• 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.

To make way for these additions, the existing stenosis codes will add the term “other.”

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

Area 3: Postprocedural Updates

You can expect to see patterns in the revisions to postprocedural complication codes.

First, watch for changes to postprocedural hemorrhage and hematoma codes, with ICD-10-CM 2017 providing distinct options for each condition within each 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 that may impact how you code anesthesia during surgery.

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