Anesthesia Coding Alert

Question: The anesthesiologist at our practice provided anesthesia for the excision of a stage IV pressure ulcer on the patient's coccyx. The physician also performed a coccygectomy during this procedure, as well as the primary suturing following the excision. What's the best way for me to code for this?

Oregon Subscriber

Answer: Start by looking at the code for the excision of the pressure ulcer -- also known as a decubitus ulcer -- and the coccygectomy: 15920 (Excision, coccygeal pressure ulcer, with coccygectomy; with primary suture).

You'll code for your anesthesiologist's participation using 01120 (Anesthesia for procedures on bony pelvis). For the diagnosis, you'll use 707.09 (Decubitus ulcer; other site).

Watch for: Surgeons may also perform coccyx removal to improve sacral bedsores, which merit diagnosis code 707.03 (... lower back).

Tip: Medicare won't cover pressure ulcer treatment when the sores develop in the hospital.

Note: Pressure ulcers will be receiving a new series of ICD-9 codes in October. You can e-mail joec@eliresearch.com for a PDF of CMS' preliminary ICD-9 codes.

-- Answers to You Be the Coder and Reader Questions were provided by Scott Groudine, MD, an Albany, N.Y., anesthesiologist; Marvel J. Hammer, RN, CPC, CCS-P, ACS-PM, CHCO, owner of MJH Consulting in Denver; and Kelly Dennis, MBA, CPC, ACS-AP, with Perfect Office Solutions of Leesburg, Fla.