Otolaryngology Coding Alert

Ever wonder if there's an ICD-9 code to turn to for a documented surgical mishap? A slew of E codes is in store for ICD-9 2010.

"There are some interesting ICD-9 2010 codes for mistakes added to E codes," notes Barbara J. Cobuzzi, MBA, CPC, CENTC, CPC-H, CPC-P, CPC-I, CHCC, president of CRN Healthcare Solutions in Tinton Falls, N.J. Before using these codes, beware of these pitfalls.

List E Code(s) Last

What are E codes? You should use them to describe external causes of injuries or accidents. You should never bill E codes as your primary code, and you should always list the E codes last. It may be necessary to assign more than one E code to fully explain each cause.

In ICD-9-CM 2010, you could solve the abovementioned surgical mishap dilemma with two codes:

• E876.6 -- Performance of operation (procedure) on patient not scheduled for surgery

• E876.7 -- Performance of correct operation (procedure) on wrong side/body part.

Warning: These two new codes describe situations that are considered "never" events. In other words, the codes represent surgical mistakes that should never happen. Adding E876.6 or E876.7 to a claim ensures "that you will not get paid and may also add malpractice exposure," says Marcella Bucknam, CPC, CCS-P, CPCH, CCS, CPC-P, COBGC, CCC, manager of compliance education for the University of Washington Physicians and Children's University Medical Group Compliance Program. "Use of these codes should be a decision that is made with your surgeon with a full understanding of the implications."

Check out some of the other "wrong" entries listed in the 2010 ICD-9-CM Alphabetic Index:

• For a wrong device implanted into correct surgical site, see E876.5 (Performance of wrong operation [procedure] on correct patient). You'd use the same code if the wrong procedure (operation) is performed on the correct patient.

• If a doctor performs an operation (procedure) on the wrong patient, you'd instead look to E876.6.

• For performing the correct operation (procedure), but on the wrong body part, side, or site, the alphabetic index directs you to E876.7.