General Surgery Coding Alert

Watch tricky hierarchy switch from ICD-9 to ICD-10.You'll have the same number of code choices and the same diagnostic distinctions for coding inguinal hernias when ICD-9 becomes ICD-10 in 2013. But elevating the bilateral/unilateral distinction from the fifth digit in ICD-9 to the fourth digit in ICD-10 confounds the one-to-one code correspondence. ICD-9 Prioritizes Gangrene, ObstructionICD-9 lists three, four-digit codes for inguinal hernia:550.0 -- Inguinal hernia with gangrene550.1 -- Inguinal hernia, with obstruction, without mention of gangrene550.9 -- Inguinal hernia, without mention of obstruction or gangrene.You should append a fifth digit to each of these codes to distinguish bilateral/unilateral and recurrent or not, as follows:0 -- unilateral or unspecified (not specified as recurrent)1 -- unilateral or unspecified, recurrent2 -- bilateral (not specified as recurrent)3 -- bilateral, recurrent. ICD-10 Prioritizes Gangrene, Obstruction, and Unilateral/Bilateral ICD-10 lists six, four digit codes for inguinal hernia:K40.0 -- Bilateral inguinal hernia, with obstruction, without gangreneK40.1 [...]