General Surgery Coding Alert

Alcoholic ascites diversifies ICD-10.

When you start using ICD-10 in 2013, the new code set won't always offer a simple one-to-one relationship to the old codes. You might have additional options that may require tweaking the way your surgeon documents a service and the way a coder reports it.

Consider this: Under ICD-9, your go-to code for cancer-related ascites is 789.51 (Malignant ascites) and for ascites related to any other condition you turn to 789.59 (Other ascites).

ICD-10 change: ICD-10 does things a little differently. True, there is a oneto-one corresponding code with the same definition for each of these -- R18.0 (Malignant ascites) and R18.8 (Other ascites). But an "excludes" note following R18 lets you in on a little secret: ICD-10 has two other codes for ascites related to specific conditions that shouldn't fall under "other ascites" code R18.8:

• K70.11 -- Alcoholic hepatitis with ascites
• K70.31 -- Alcoholic cirrhosis of liver with ascites.

The corresponding ICD-9 codes (571.1, Acute alcoholic hepatitis) and 571.2 (Alcoholic cirrhosis of liver) don't mention ascites. You would currently need to report both 571.x and 789.59 to fully describe the condition captured by K70.11 or K70.31 alone.

Remember: When ICD-10 goes into effect on Oct. 1, 2013, you should apply the codes and official guidelines in effect at that time. Learn more about ICD-10 at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update. You can access a handy ICD-9 to ICD-10 conversion tool at https://www.aapc.com/codes/.