CPT Question
Open Procedure:
Laparotomy with transcystic duct common bile duct exploration with extraction of stone or calculus.
Ans: 47420
Code Description:
47420 Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; without [transduodenal sphincterotomy or sphincteroplasty]
47425 with transduodenal sphincterotomy or sphincteroplasty
Common ICD-9-CM Respiratory System Diagnosis Codes
Dyspnea- 786.09
Shortness of Breath- 786.05
Wheezing- 786.07
Cough- 786.2
Hyperventilation- 786.01
Orthopnea- 786.02
Apnea- 786.03
Tachypnea- 786.06
Respiratory distress, Respiratory insufficiency- 786.09
Respiratory abnormality, unspecified- 786.00
Sinus pain or Sinus congestion- 478.19
Chest congestion- 786.9
Lung Congestion- 786.9
Pleurisy or Pleuritis- 511.0
Bronchitis- 490
Bronchitis acute or subacute- 466.0
Asthmatic Bronchitis- 493.90
Chronic Bronchitis- 491.9
Obstructive Bronchitis- 491.20
Exudative Bronchtis- 466.0
Bronchiolitis, acute- 466.19
Sinusitis(Chronic)- 473.9
Acute Sinusutis- 461.9
Asthma- 493.90
Asthma Child (Age <=17)- 493.00
Asthma Exacerbation- 493.92
COPD- 496
COPD with Asthma- 493.20
COPD exacerbation- 491.21
Pneumonia- 486
Influenza- 487.1
Influenza with Bronchitis- 487.1
Bronchospasm- 519.11
with Asthma- 493.90
Bronchiolitis, acute- 466.19
Bronchitis- 490
Chronic obstructive pulmonary disease (COPD)- 496
Shortness of Breath- 786.05
Wheezing- 786.07
Cough- 786.2
Hyperventilation- 786.01
Orthopnea- 786.02
Apnea- 786.03
Tachypnea- 786.06
Respiratory distress, Respiratory insufficiency- 786.09
Respiratory abnormality, unspecified- 786.00
Sinus pain or Sinus congestion- 478.19
Chest congestion- 786.9
Lung Congestion- 786.9
Pleurisy or Pleuritis- 511.0
Bronchitis- 490
Bronchitis acute or subacute- 466.0
Asthmatic Bronchitis- 493.90
Chronic Bronchitis- 491.9
Obstructive Bronchitis- 491.20
Exudative Bronchtis- 466.0
Bronchiolitis, acute- 466.19
Sinusitis(Chronic)- 473.9
Acute Sinusutis- 461.9
Asthma- 493.90
Asthma Child (Age <=17)- 493.00
Asthma Exacerbation- 493.92
COPD- 496
COPD with Asthma- 493.20
COPD exacerbation- 491.21
Pneumonia- 486
Influenza- 487.1
Influenza with Bronchitis- 487.1
Bronchospasm- 519.11
with Asthma- 493.90
Bronchiolitis, acute- 466.19
Bronchitis- 490
Chronic obstructive pulmonary disease (COPD)- 496
Global Surgical Period CPT and modifier 25 and 57
Modifier 25 used when seperately identifiable E/M service is rendered on the same day of the procedure or other services. If a patient comes with wound in the hand and the physician evaluates the patient and documents the assessment as hand laceration then this is an an E/M service. The physician then performs an wound closure using say staples. Here wound closure is another seperate procedure or service provided by the physician on the same day. Hence modifier 25 is required. If on the other hand, a patient arrives with chest pain and the diagnosis is myocardial infarction, and the physician performes a CABG this wound require the use of modifier 57.
CPT global period includes one related E/M encounter prior to or on the date of procedure resulting in the decision for surgery. The E/M level will require modifier 57 (Decision for Surgery).
The choice of modifiers 57 or 25 depends on the global period of the procedures. Global period for CPT procedures differ from procedure to procedure.
57 modifier is assigned for major surgical procedures or procedures with 90 day global period. If the global period of the procedure is not 90 days or the procedure is not a major surgical procedure then modifier 25 should be used. The global period of major surgical procedures begin one day prior to actual procedure.
The global package of CPT procedure codes is divided into three parts pre-operative services, intra-operative services, and post-operative care. The post operative care includes all related followup visits during the global period.
Modifiers
54 Surgical care only is used to report intra-operative services.
55 Postoperative Management is used to indicate postoperative services.
There are some procedure that can be performed in stages rather the same procedure be performed at once. Modifier 58 should be appened to a staged procedure done by the same physician during the global period of the original procedure.
58 Staged or related procedure or service by same physician during the postoperatuive period.
CPT global period includes one related E/M encounter prior to or on the date of procedure resulting in the decision for surgery. The E/M level will require modifier 57 (Decision for Surgery).
The choice of modifiers 57 or 25 depends on the global period of the procedures. Global period for CPT procedures differ from procedure to procedure.
57 modifier is assigned for major surgical procedures or procedures with 90 day global period. If the global period of the procedure is not 90 days or the procedure is not a major surgical procedure then modifier 25 should be used. The global period of major surgical procedures begin one day prior to actual procedure.
The global package of CPT procedure codes is divided into three parts pre-operative services, intra-operative services, and post-operative care. The post operative care includes all related followup visits during the global period.
Modifiers
54 Surgical care only is used to report intra-operative services.
55 Postoperative Management is used to indicate postoperative services.
There are some procedure that can be performed in stages rather the same procedure be performed at once. Modifier 58 should be appened to a staged procedure done by the same physician during the global period of the original procedure.
58 Staged or related procedure or service by same physician during the postoperatuive period.
OPHTHALMOLOGY ABBREVATIONS AND CODES
SMA - Simple myopia astigmatism (367.1, 367.20)
SHA - simple hyperoptia astigmatism (367.0, 367.20)
CHAP - Compound hyperopia, astigmatism, presbyopia (coded for all three) (367.0, 367.20, 367.4)
CHMP - Compound hyperopia, myopia, presbyopia (coded for all three)
CHA - compound hyperopia, astigmatism (coded for both)
CMA - compound myopia, astigmatism (367.1 & 367.20)
CMAP - compound myopia, astigmatism and presbyopia (367.0, 367.20 and 367.4)
SH - simple hyperopia (367.0)
SM - simple myopia (367.1)
MHA - Myopia, hyperopia, astigmatism (coded for all three)
SAP - Simple astigmatism, presbyopia (coded for both)
CME – Compound myopia, esotropia. (367.1 and 378.00)
Wherever there is routine or yearly eye exam coded as V72.0
Wherever there is screening for glaucoma and the condition is suspect coded as V80.2
PDR: Proliferative diabetic retinopathy (250.50, 362.02)
NPDR: Non-proliferative diabetic retinopathy (250.50, 362.01)
CVO or CRVO or CRVT – Central vein occlusion, central retinal vein occlusion or central retinal vein thrombosis (362.35)
CACD – Central areolar choroidal dystrophy
CSC – Central serous chorioretinopathy.
RPE detachment: Retinal pigment epithelium detachment.
PDR: Pattern dystrophy of retina.
CSME: Cotton-spot macular edema. (362.83)
Decreased NV: Decreased Near vision.
DRUSEN: 362.57
NPDR OU: Non proliferative diabetic retinopathy, both eyes 250.50
CR Scar: Old chorioretinal scar
Borderline IOP increase (intraocular pressure): 365.00, not 365.01 (feedback from Beth)
HVF: Humphrey visual field
COP: Capillary osmotic pressure
SHA - simple hyperoptia astigmatism (367.0, 367.20)
CHAP - Compound hyperopia, astigmatism, presbyopia (coded for all three) (367.0, 367.20, 367.4)
CHMP - Compound hyperopia, myopia, presbyopia (coded for all three)
CHA - compound hyperopia, astigmatism (coded for both)
CMA - compound myopia, astigmatism (367.1 & 367.20)
CMAP - compound myopia, astigmatism and presbyopia (367.0, 367.20 and 367.4)
SH - simple hyperopia (367.0)
SM - simple myopia (367.1)
MHA - Myopia, hyperopia, astigmatism (coded for all three)
SAP - Simple astigmatism, presbyopia (coded for both)
CME – Compound myopia, esotropia. (367.1 and 378.00)
Wherever there is routine or yearly eye exam coded as V72.0
Wherever there is screening for glaucoma and the condition is suspect coded as V80.2
PDR: Proliferative diabetic retinopathy (250.50, 362.02)
NPDR: Non-proliferative diabetic retinopathy (250.50, 362.01)
CVO or CRVO or CRVT – Central vein occlusion, central retinal vein occlusion or central retinal vein thrombosis (362.35)
CACD – Central areolar choroidal dystrophy
CSC – Central serous chorioretinopathy.
RPE detachment: Retinal pigment epithelium detachment.
PDR: Pattern dystrophy of retina.
CSME: Cotton-spot macular edema. (362.83)
Decreased NV: Decreased Near vision.
DRUSEN: 362.57
NPDR OU: Non proliferative diabetic retinopathy, both eyes 250.50
CR Scar: Old chorioretinal scar
Borderline IOP increase (intraocular pressure): 365.00, not 365.01 (feedback from Beth)
HVF: Humphrey visual field
COP: Capillary osmotic pressure
ICD-9-CM Vaccination codes
VAC ABBREVIATION/DRUG NAME CODE VACCINATION NAME
DT: V06.5 Diphtheria, Tetanus
DTaP: V06.1 Acellular Pertussis w/Diphtheria and Tetanus
DTaP + HCB + IPV: V06.8 Diphtheria, Tetanus, Pertussis, HCB, Poliomyelitis
DTP: V06.1 Diphtheria, Tetanus, Pertussis
DTP + HIB: V06.8 Diphtheria, Tetanus, Pertussis + Haemophilus B Influenza
DTP + IPV: V06.3 Diphtheria, Tetanus, Pertussis + Inactivated Polio
HAV: V05.3 Hepatitis A Vaccination
HbOC: V03.81 Haemophilus B Influenza
HBV: V05.3 Hepatitis B Vaccination
Hereditary/Metabolic Screening: V77.7 Hereditary/Metabolic Screening
H-flu: V03.81 Haemophilus B Influenza
HIB: V03.81 Haemophilus B Influenza
Influenza: - visit date 09/30/03 and before V04.8 Influenza (more commonly known as the "flu shot")
Influenza: - visit date 10/01/03 and after V04.81 Influenza (more commonly known as the "flu shot")
IPV: V04.0 Inactivated Polio
Lead Screening: V82.5 Lead Screening
Lyme Disease: V03.89 Lyme Disease
Meningocococcal: V03.89 Meningocococcal--for meningitis
MMR: V06.4 Measles, Mumps, Rubella
Pb screening: V82.5 Lead Screening (Pb = lead screening)
PCV: V03.82 Pneumococcal Conjugate Vaccination
PCV 7 V03.82 Pneumococcal 7-Valent Conjugate Vaccination
Pediarix V06.8 Diphtheria, Tetanus, Pertussis, Hepatitis B, Poliomyelitis
Pneumovax V03.82 Pneumococcal Vaccination
PPD (screening) V74.1 Purified Protein Derivative (of tuberculin)
Prevnar V03.82 Pneumococcal Vaccination
PRP-OMP V03.81 Haemophilus B Influenza
PRP-T V03.81 Haemophilus B Influenza
Rabies V04.5 Rabies
Recombivax V05.3 Hepatitis B Vaccination
RSV - visit date 09/30/03 and before V05.8 Respiratory Synctial Virus Vaccination
RSV - visit date 10/01/03 and after V04.82 Respiratory Synctial Virus Vaccination
Synagis - visit date 09/30/03 and before V05.8 Respiratory Synctial Virus Vaccination
Synagis - visit date 10/01/03 and after V04.82 Respiratory Synctial Virus Vaccination
Td V06.5 Tetanus, Diphtheria
Varicella V05.4 Varicella (more commonly known as chicken pox vaccination)
Menectra V03.89 Meningocococcal--for meningitis
TriHiBit V06.8 DTaP-Hib
Proquad V06.8 MMRV (measles, mumps, rubella, and varicella vaccine)
RotaTeq V04.89 RotaVirus
Gardasil (HPV) V04.89 Human Papilloma Virus
Tetanus V03.7 Tetanus Toxide alone
DT: V06.5 Diphtheria, Tetanus
DTaP: V06.1 Acellular Pertussis w/Diphtheria and Tetanus
DTaP + HCB + IPV: V06.8 Diphtheria, Tetanus, Pertussis, HCB, Poliomyelitis
DTP: V06.1 Diphtheria, Tetanus, Pertussis
DTP + HIB: V06.8 Diphtheria, Tetanus, Pertussis + Haemophilus B Influenza
DTP + IPV: V06.3 Diphtheria, Tetanus, Pertussis + Inactivated Polio
HAV: V05.3 Hepatitis A Vaccination
HbOC: V03.81 Haemophilus B Influenza
HBV: V05.3 Hepatitis B Vaccination
Hereditary/Metabolic Screening: V77.7 Hereditary/Metabolic Screening
H-flu: V03.81 Haemophilus B Influenza
HIB: V03.81 Haemophilus B Influenza
Influenza: - visit date 09/30/03 and before V04.8 Influenza (more commonly known as the "flu shot")
Influenza: - visit date 10/01/03 and after V04.81 Influenza (more commonly known as the "flu shot")
IPV: V04.0 Inactivated Polio
Lead Screening: V82.5 Lead Screening
Lyme Disease: V03.89 Lyme Disease
Meningocococcal: V03.89 Meningocococcal--for meningitis
MMR: V06.4 Measles, Mumps, Rubella
Pb screening: V82.5 Lead Screening (Pb = lead screening)
PCV: V03.82 Pneumococcal Conjugate Vaccination
PCV 7 V03.82 Pneumococcal 7-Valent Conjugate Vaccination
Pediarix V06.8 Diphtheria, Tetanus, Pertussis, Hepatitis B, Poliomyelitis
Pneumovax V03.82 Pneumococcal Vaccination
PPD (screening) V74.1 Purified Protein Derivative (of tuberculin)
Prevnar V03.82 Pneumococcal Vaccination
PRP-OMP V03.81 Haemophilus B Influenza
PRP-T V03.81 Haemophilus B Influenza
Rabies V04.5 Rabies
Recombivax V05.3 Hepatitis B Vaccination
RSV - visit date 09/30/03 and before V05.8 Respiratory Synctial Virus Vaccination
RSV - visit date 10/01/03 and after V04.82 Respiratory Synctial Virus Vaccination
Synagis - visit date 09/30/03 and before V05.8 Respiratory Synctial Virus Vaccination
Synagis - visit date 10/01/03 and after V04.82 Respiratory Synctial Virus Vaccination
Td V06.5 Tetanus, Diphtheria
Varicella V05.4 Varicella (more commonly known as chicken pox vaccination)
Menectra V03.89 Meningocococcal--for meningitis
TriHiBit V06.8 DTaP-Hib
Proquad V06.8 MMRV (measles, mumps, rubella, and varicella vaccine)
RotaTeq V04.89 RotaVirus
Gardasil (HPV) V04.89 Human Papilloma Virus
Tetanus V03.7 Tetanus Toxide alone
What are types of Splints and which Splints need CPT coding ??
Custom splints are codes whereas prefabricated splints are not coded.
What are custom and prefabricated splints?
Custom: Fitted to patient, specifically, not a supply.
Prefabricated: Supply, taken off shelf and applied to patient.
OCL (plaster, cloth cover and padding. And Orthoglass (fiberglass) are formed to the patient or customized. They are always coded and not a supply.
Thumb spica is formed with plaster, custom.
Sugar tong splints are formed with plaster, custom.
Colles’ splint is prefabricated.
Posterior ankle splint, stirrup splint is made of plaster, custom.
Bledsoe brace is prefabricated.
Air cell, foam or gel components are prefabricated or a supply.
Figure of eight can be customized or prefabricated. Check the documentation.
Velcro, finger splints are mostly prefabricated, but check documentation.
Knee splints are prefabricated, unless patient is too large for the splint, at which time it will be formed specifically to the patient.
TYPES OF SPLINTS:
BOXER SPLINT - custom
ANKLE STIRRUP SPLINT (ANKLE SUGARTONG SPLINT) – custom
COLLES’ SPLINT- pre-fab
LONG ARM SPLINT - custom
RADIAL & ULNAR GUTTER SPLINT - custom
SHORT ARM VOLAR SPLINT - custom
SUGAR TONG SPLINT - custom
LONG LEG SPLINT – custom (not a pre-fab knee immobilizer)
POSTERIOR ANKLE SPLINT – custom
POSTERIOR ELBOW SPLINT - custom
PLASTER SPLINT – custom
OCL (PLASTER) SPLINT – custom
ORTHOGLASS (FIBERGLASS) - custom
STIRRUP SPLINT - custom
DOUBLE SUGAR TONG SPLINT - custom
LONG DOUBLE SUGAR TONG SPLINT - custom
THUMB SPICA SPLINT - custom
MEDIAL LATERAL SPLINT - custom
DORSAL VOLAR SPLINT - custom
COAPTATION SPLINT - custom
COCKUP SPLINT – prefabricated
KNEE IMMOBILIZER – prefabricated
AIRCAST / AIRSPLINT – prefabricated
HARD SHOE – prefabricated
BLEDSOE BRACE – prefabricated
JONES DRESSING/BULKY JONES – prefabricated
POSTERIOR KNEE SPLINT – prefabricated
ALUMINUM FINGER SPLINT - prefabricated
VOLAR FINGER SPLINTS – either
What are custom and prefabricated splints?
Custom: Fitted to patient, specifically, not a supply.
Prefabricated: Supply, taken off shelf and applied to patient.
OCL (plaster, cloth cover and padding. And Orthoglass (fiberglass) are formed to the patient or customized. They are always coded and not a supply.
Thumb spica is formed with plaster, custom.
Sugar tong splints are formed with plaster, custom.
Colles’ splint is prefabricated.
Posterior ankle splint, stirrup splint is made of plaster, custom.
Bledsoe brace is prefabricated.
Air cell, foam or gel components are prefabricated or a supply.
Figure of eight can be customized or prefabricated. Check the documentation.
Velcro, finger splints are mostly prefabricated, but check documentation.
Knee splints are prefabricated, unless patient is too large for the splint, at which time it will be formed specifically to the patient.
TYPES OF SPLINTS:
BOXER SPLINT - custom
ANKLE STIRRUP SPLINT (ANKLE SUGARTONG SPLINT) – custom
COLLES’ SPLINT- pre-fab
LONG ARM SPLINT - custom
RADIAL & ULNAR GUTTER SPLINT - custom
SHORT ARM VOLAR SPLINT - custom
SUGAR TONG SPLINT - custom
LONG LEG SPLINT – custom (not a pre-fab knee immobilizer)
POSTERIOR ANKLE SPLINT – custom
POSTERIOR ELBOW SPLINT - custom
PLASTER SPLINT – custom
OCL (PLASTER) SPLINT – custom
ORTHOGLASS (FIBERGLASS) - custom
STIRRUP SPLINT - custom
DOUBLE SUGAR TONG SPLINT - custom
LONG DOUBLE SUGAR TONG SPLINT - custom
THUMB SPICA SPLINT - custom
MEDIAL LATERAL SPLINT - custom
DORSAL VOLAR SPLINT - custom
COAPTATION SPLINT - custom
COCKUP SPLINT – prefabricated
KNEE IMMOBILIZER – prefabricated
AIRCAST / AIRSPLINT – prefabricated
HARD SHOE – prefabricated
BLEDSOE BRACE – prefabricated
JONES DRESSING/BULKY JONES – prefabricated
POSTERIOR KNEE SPLINT – prefabricated
ALUMINUM FINGER SPLINT - prefabricated
VOLAR FINGER SPLINTS – either
Open wound coding ICD: 870-897 CPT 12001-13160
Coding open wound in ICD-9-CM 870-897
Open wound or lacerations involves break in the skin surface and includes animal bite, avulsion, cut, puncture wound, and traumatic amputations. If the wound is deep then surgical closure using staples or sutures is carried out to allow the wound to heal and then after a few weeks the staples are removed. Dermabond glue or wound adhesives is also used and is persumed as surgical closure according to CPT and will result in same codes as staples or sutures. If the wound is not so deep then closure by sterri strips is sufficient. When wounds are closed using sterri strips the procedure does not require any CPT code and the service is included in E/M services.
Removal of sutures or staples is also a part of E/M services althought there are ICD procedure codes available depending upon the anatomical site.
Open wound or lacerations involves break in the skin surface and includes animal bite, avulsion, cut, puncture wound, and traumatic amputations. If the wound is deep then surgical closure using staples or sutures is carried out to allow the wound to heal and then after a few weeks the staples are removed. Dermabond glue or wound adhesives is also used and is persumed as surgical closure according to CPT and will result in same codes as staples or sutures. If the wound is not so deep then closure by sterri strips is sufficient. When wounds are closed using sterri strips the procedure does not require any CPT code and the service is included in E/M services.
Removal of sutures or staples is also a part of E/M services althought there are ICD procedure codes available depending upon the anatomical site.
Superficial injury, friction burn, Blister, Insect bite, Superficial foreign body codes ICD-9-CM: 910-919
910-919 categories in ICD-9-CM stands for superficial injury of different anatomical sites with fourth digit describing the type of superficial injury as below. While coding superficial injuries special attention should be given to find if there is any infection and chose the code accordingly. An additional code can be used to specify the type of infection, eg cellulitis etc.
910 Superficial injury of face, neck, and scalp except eye
910.0 Abrasion or friction burn without mention of infection
910.1 Abrasion or friction burn, infected
910.2 Blister without mention of infection
910.3 Blister, infected
910.4 Insect bite, nonvenomous, without mention of infection
910.5 Insect bite, nonvenomous, infected
910.6 Superficial foreign body (splinter) without major open wound and without mention of infection
910.7 Superficial foreign body (splinter) without major open wound, infected
910.8 Other and unspecified superficial injury of face, neck, and scalp without mention of infection
910.9 Other and unspecified superficial injury of face, neck, and scalp, infected
The following categories are used for other anotomical sites with additional 4th digit depending upon the scenario
911 Superficial injury of trunk
abdominal wall, anus, back, breast, buttock, chest wall, flank, groin , interscapular region, labium (majus) (minus), penis, perineum, scrotum, testis, vagina, vulva
912 Superficial injury of shoulder and upper arm
axlla and scapular region
913 Superficial injury of elbow, forearm, and wrist
914 Superficial injury of hand(s) except finger(s) alone
915 Superficial injury of finger(s)
fingernail and thumb (nail)
916 Superficial injury of hip, thigh, leg, and ankle
917 Superficial injury of foot and toe(s)
heel and toenail
918 Superficial injury of eye and adnexa
919 Superficial injury of other, multiple, and unspecified sites
910 Superficial injury of face, neck, and scalp except eye
910.0 Abrasion or friction burn without mention of infection
910.1 Abrasion or friction burn, infected
910.2 Blister without mention of infection
910.3 Blister, infected
910.4 Insect bite, nonvenomous, without mention of infection
910.5 Insect bite, nonvenomous, infected
910.6 Superficial foreign body (splinter) without major open wound and without mention of infection
910.7 Superficial foreign body (splinter) without major open wound, infected
910.8 Other and unspecified superficial injury of face, neck, and scalp without mention of infection
910.9 Other and unspecified superficial injury of face, neck, and scalp, infected
The following categories are used for other anotomical sites with additional 4th digit depending upon the scenario
911 Superficial injury of trunk
abdominal wall, anus, back, breast, buttock, chest wall, flank, groin , interscapular region, labium (majus) (minus), penis, perineum, scrotum, testis, vagina, vulva
912 Superficial injury of shoulder and upper arm
axlla and scapular region
913 Superficial injury of elbow, forearm, and wrist
914 Superficial injury of hand(s) except finger(s) alone
915 Superficial injury of finger(s)
fingernail and thumb (nail)
916 Superficial injury of hip, thigh, leg, and ankle
917 Superficial injury of foot and toe(s)
heel and toenail
918 Superficial injury of eye and adnexa
919 Superficial injury of other, multiple, and unspecified sites
Contusion, Bruise, and Hematoma ICD-9-CM: 920-924
Contusion, Bruise, and Hematoma are synonyms in ICD-9-CM and lead to same codes depending upon anatomical site of the body.
Codes Anatomical site
920 Contusion of face, scalp, and neck except eye(s)
Cheek, Ear (auricle), Gum, Lip, Mandibular joint area, Nose, Throat, Neck,
921 Contusion of eye and adnexa
921.0 Black eye, not otherwise specified
921.1 Contusion of eyelids and periocular area
921.2 Contusion of orbital tissues
921.3 Contusion of eyeball
921.9 Unspecified contusion of eye
922 Contusion of trunk
922.0 Breast
922.1 Chest wall
922.2 Abdominal wall
includes Flank and Groin
922.3 Back
922.4 Genital organs
Includes labium (majus) (minus), Penis, Perineum, scotum, Testis, vulva
922.8 Multiple sites of trunk
922.9 Unspecified part
Trunk NOS
923 Contusion of upper limb
923.0 Shoulder and upper arm
923.1 Elbow and forearm
923.2 Wrist and hand(s), except finger(s) alone
923.3 Finger
Includes: Fingernail and Thumb (nail)
923.8 Multiple sites of upper limb
923.9 Unspecified part of upper limb
Arm NOS
924 Contusion of lower limb and of other and unspecified sites
924.0 Hip and thigh
924.00 Thigh
924.01 Hip
924.1 Knee and lower leg
924.10 Lower leg
924.11 Knee
924.2 Ankle and foot, excluding toe(s)
924.20 Foot
Includes: Heel
924.21 Ankle
924.3 Toe
Includes: Toenail
924.4 Multiple sites of lower limb
924.5 Unspecified part of lower limb
Includes: Leg NOS
924.8 Multiple sites, not elsewhere classified
924.9 Unspecified site
Hematoma complicating a procedure ICD 9 Codes
998.11 - Hemorrhage complicating a procedure
998.12 - Hematoma complicating a procedure
998.13 - Seroma complicating a procedure
Codes Anatomical site
920 Contusion of face, scalp, and neck except eye(s)
Cheek, Ear (auricle), Gum, Lip, Mandibular joint area, Nose, Throat, Neck,
921 Contusion of eye and adnexa
921.0 Black eye, not otherwise specified
921.1 Contusion of eyelids and periocular area
921.2 Contusion of orbital tissues
921.3 Contusion of eyeball
921.9 Unspecified contusion of eye
922 Contusion of trunk
922.0 Breast
922.1 Chest wall
922.2 Abdominal wall
includes Flank and Groin
922.3 Back
922.4 Genital organs
Includes labium (majus) (minus), Penis, Perineum, scotum, Testis, vulva
922.8 Multiple sites of trunk
922.9 Unspecified part
Trunk NOS
923 Contusion of upper limb
923.0 Shoulder and upper arm
923.1 Elbow and forearm
923.2 Wrist and hand(s), except finger(s) alone
923.3 Finger
Includes: Fingernail and Thumb (nail)
923.8 Multiple sites of upper limb
923.9 Unspecified part of upper limb
Arm NOS
924 Contusion of lower limb and of other and unspecified sites
924.0 Hip and thigh
924.00 Thigh
924.01 Hip
924.1 Knee and lower leg
924.10 Lower leg
924.11 Knee
924.2 Ankle and foot, excluding toe(s)
924.20 Foot
Includes: Heel
924.21 Ankle
924.3 Toe
Includes: Toenail
924.4 Multiple sites of lower limb
924.5 Unspecified part of lower limb
Includes: Leg NOS
924.8 Multiple sites, not elsewhere classified
924.9 Unspecified site
Hematoma complicating a procedure ICD 9 Codes
998.11 - Hemorrhage complicating a procedure
998.12 - Hematoma complicating a procedure
998.13 - Seroma complicating a procedure
Removal of Foreign Body Skin and Subcutaneously Tissue CPT: 10120-10121
Removal of foreign body from skin and subcutaneously tissue
CPT codes
10120 Incision and removal of foreign body, subcutaneous tissues; simple
10121 Complicated
ICD-9-CM Procedure code
86.05 Incision W Removal Of FB/Device From Skin/Subcu Tissue
However these codes are used to code for foreign body removal till subcutaneously tissue. For deep penetrating foreign body respective anatomical sections of CPT assistant should be seen.
CPT codes
10120 Incision and removal of foreign body, subcutaneous tissues; simple
10121 Complicated
ICD-9-CM Procedure code
86.05 Incision W Removal Of FB/Device From Skin/Subcu Tissue
However these codes are used to code for foreign body removal till subcutaneously tissue. For deep penetrating foreign body respective anatomical sections of CPT assistant should be seen.
Incision and Drainage CPT: 10040-10180
Incision and Drainage CPT: 10040-10180
What is the difference differentiate between incision and drainage and aspiration??
Incision and drainge requires incision through the skin and then drainage of the abscess, cyst, or paronyhia whereas in the aspiration procedure a needle is used to puncture the area and then aspiration is done using a syringe or suctioned.
CPT does not define what "complicated" means. It has been left to the physician depending upon the the level of difficulty involved in the procedure.
I&D of abscess:
10060 Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single
10061 Complicated or multiple
The corresponding ICD procedures codes for incision and drainage of skin:
86.04 Incision W Drainage Of Skin/Subcutan Tissue NEC
Along with I&D if the wound requires closure with "packing" then it can be considered as complicated even if single abscess is involved and 10061 can be coded.
Incision and drainage of Pilomidal Cyst:
10080 Incision and drainage of pilonidal cyst; simple
10081 complicated
ICD: 86.03 Incision Of Pilonidal Sinus/Cyst
I&D of hematoma, seroma, or fluid collection:
10140 Incision and drainage of hematoma, seroma or fluid collection
10160 Puncture aspiration of abscess, hematoma, bulla, or cyst
I&D of complex, postoperative wound infection:
10180 Incision and drainage, complex, postoperative wound infection
Puncture aspiration:
10160 Puncture aspiration of abscess, hematoma, bulla, or cyst
ICD: 86.01 Aspiration of skin and subcutaneous tissue (Includes aspiration of abscess, hematoma, seroma of of nail, skin, or subcutaneous tissue)
ICD-9-CM codes:
Abscess: 682 category
What is the difference differentiate between incision and drainage and aspiration??
Incision and drainge requires incision through the skin and then drainage of the abscess, cyst, or paronyhia whereas in the aspiration procedure a needle is used to puncture the area and then aspiration is done using a syringe or suctioned.
CPT does not define what "complicated" means. It has been left to the physician depending upon the the level of difficulty involved in the procedure.
I&D of abscess:
10060 Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single
10061 Complicated or multiple
The corresponding ICD procedures codes for incision and drainage of skin:
86.04 Incision W Drainage Of Skin/Subcutan Tissue NEC
Along with I&D if the wound requires closure with "packing" then it can be considered as complicated even if single abscess is involved and 10061 can be coded.
Incision and drainage of Pilomidal Cyst:
10080 Incision and drainage of pilonidal cyst; simple
10081 complicated
ICD: 86.03 Incision Of Pilonidal Sinus/Cyst
I&D of hematoma, seroma, or fluid collection:
10140 Incision and drainage of hematoma, seroma or fluid collection
10160 Puncture aspiration of abscess, hematoma, bulla, or cyst
I&D of complex, postoperative wound infection:
10180 Incision and drainage, complex, postoperative wound infection
Puncture aspiration:
10160 Puncture aspiration of abscess, hematoma, bulla, or cyst
ICD: 86.01 Aspiration of skin and subcutaneous tissue (Includes aspiration of abscess, hematoma, seroma of of nail, skin, or subcutaneous tissue)
ICD-9-CM codes:
Abscess: 682 category
Sepsis, Septicemia- ICD-9-CM: 995.91 ICD 10: A40 A41.0
Sepsis, is a serious medical condition characterized by a whole-body inflammatory state (called a systemic inflammatory response syndrome or SIRS). Septicemia refers to the presence of pathogenic organisms in the blood-stream, leading to sepsis.
Severe sepsis occurs when sepsis leads to organ dysfunction. Sepsis can lead to septic shock, multiple organ dysfunction syndrome (formerly known as multiple organ failure), and death.
Septicemia >>Sepsis (SIRS)>>Severe sepsis(sepsis + organ dysfunction)
ICD-9-CM Coding
septicemia = 038.9 (Unspecified septicemia or organism not specified)
sepsis = 995.91 + 038.9 (if the type of infection or organism is not specified)
Severe Sepsis = 995.92 + 038.9 (if the type of infection or organism is not specified) + Code for acute organ dysfunction such as acute renal failure, acute respiratory failure (518.81), critical illness myopathy (359.81), encephalopathy (348.31), septic shock (785.52), etc.
Note 1: No Ecodes are required while codes 995.92 and 995.91 are coded.
Note 2: Codes from subcategory 995.9 should never be assigned as a principal diagnosis.
Severe sepsis occurs when sepsis leads to organ dysfunction. Sepsis can lead to septic shock, multiple organ dysfunction syndrome (formerly known as multiple organ failure), and death.
Septicemia >>Sepsis (SIRS)>>Severe sepsis(sepsis + organ dysfunction)
ICD-9-CM Coding
septicemia = 038.9 (Unspecified septicemia or organism not specified)
sepsis = 995.91 + 038.9 (if the type of infection or organism is not specified)
Severe Sepsis = 995.92 + 038.9 (if the type of infection or organism is not specified) + Code for acute organ dysfunction such as acute renal failure, acute respiratory failure (518.81), critical illness myopathy (359.81), encephalopathy (348.31), septic shock (785.52), etc.
Note 1: No Ecodes are required while codes 995.92 and 995.91 are coded.
Note 2: Codes from subcategory 995.9 should never be assigned as a principal diagnosis.
HIV/AIDS ICD-9-CM: V08, 042 ICD-10: B20-B24
Human immunodeficiency virus (HIV) is a viral infection that can lead to acquired immunodeficiency syndrome (AIDS). These individuals mostly die from opportunistic infections or malignancies associated with the progressive failure of the immune system. Without treatment HIV will progress to AIDS after 10-15 years. Without antiretroviral therapy, death normally occurs within a year.
ICD-9-CM codes
V08 HIV positive NOS
This code is to be used when for HIV infection only to indicate that the disease has not progressed to advanced stage of AIDS. HIV positive patient will not manifest any opportunistic infections or symptoms unless the disease progresses to AIDS. So V08 is used untill the patient develops HIV related symptoms. Terms indicating HIV are HIV positive, known HIV, HIV test positive, HIV,
042 AIDS
Once the patient starts developing HIV related symptoms it indicates that the disease has progressed to AIDS and ICD-9-CM directs to use the code 042 for such conditions. In addition, the associated symptom or condition is also coded as secondary diagnosis. Once a patient developes AIDS then 042 should be used for further visits even if there is no documentation of associated symptoms or conditions. Some of the conditions that indicated that the disease has progressed to AIDS are Kaposi's Sarcoma and thrush. Some terms which also indicated AIDS are ARC and HIV infection symptomatic.
ICD-9-CM Codes for HIV Testing
V73.89 Other specified viral diseases
When a patient comes for HIV testing V73.89 is assigned as the principle diagnosis. If in addition to HIV testing the physician also counsels the patient regarding HIV then v65.44 is also used as secondary Dx.
If the test result is positive then V08 shoould be used and if the tests are inconclusive then 795.71 should be assigned.
795.71, Inconclusive serologic test for Human Immunodeficiency Virus [HIV].
ICD-9-CM codes
V08 HIV positive NOS
This code is to be used when for HIV infection only to indicate that the disease has not progressed to advanced stage of AIDS. HIV positive patient will not manifest any opportunistic infections or symptoms unless the disease progresses to AIDS. So V08 is used untill the patient develops HIV related symptoms. Terms indicating HIV are HIV positive, known HIV, HIV test positive, HIV,
042 AIDS
Once the patient starts developing HIV related symptoms it indicates that the disease has progressed to AIDS and ICD-9-CM directs to use the code 042 for such conditions. In addition, the associated symptom or condition is also coded as secondary diagnosis. Once a patient developes AIDS then 042 should be used for further visits even if there is no documentation of associated symptoms or conditions. Some of the conditions that indicated that the disease has progressed to AIDS are Kaposi's Sarcoma and thrush. Some terms which also indicated AIDS are ARC and HIV infection symptomatic.
ICD-9-CM Codes for HIV Testing
V73.89 Other specified viral diseases
When a patient comes for HIV testing V73.89 is assigned as the principle diagnosis. If in addition to HIV testing the physician also counsels the patient regarding HIV then v65.44 is also used as secondary Dx.
If the test result is positive then V08 shoould be used and if the tests are inconclusive then 795.71 should be assigned.
795.71, Inconclusive serologic test for Human Immunodeficiency Virus [HIV].
Cerebrovsacular Accident - CVA or Stroke
Due to CVA the affected area of the brain is unable to function, leading to inability to move one or more limbs on one side of the body, inability to understand or formulate speech or inability to see one side of the visual field.
CVA should be differentiated from transient ischemic attack, which is a related syndrome of stroke symptoms that resolve completely within 24 hours.
CVA or Stroke or cerebrovascular accident: ICD-10 I61.-I64.
ICD-9 434.91
ICD-9-CM states that CVA should be coded as long as the patient is receiving treatment and till the patient is discharged. Once the patient is discharged and for further visits late effect codes of CVA (438 category) should be used.
The late effects of CVA are neurological deficits that persist after initial onset of CVA or may arise at any time later. Some of these condition are
aphasia (inability to speak)
apraxia (altered voluntary movements)
visual field defect
memory deficits or cognitive deficits (involvement of temporal lobe)
hemiplegia or hemiparesis
ataxia
Although aphasia, apraxia, cognitive deficits, hemeplegia, or ataxia are not coded at the time of admission when the patient is diagnosed with CVA, but when the patient presents with these conditions a later date then a code from category 438 should be used to indicate that these are late effects of CVA.
ICD-9-CM proveides a V code V12.54 to indicate history of CVA. Codes from category 438 and CVA should not be assigned at the same visit of date either of these shluld be assigned.
Codes from category 438 can be assigned together with codes from 430-437 when a patient has current CVA and deficits from an old CVA.
In practical cases physicians do not document any relationship between neurological deficits and history CVA in the medical records. So when a patent has hemeplagia and also has a history of CVA codes from 438 catetogy i.e 438.20 are assigned instead of coding history of CVA (V12.54) and hemeplagia (368.10)seperately. The same rule applies to other neurological deficitis such as ataxia, aphasia, cognitive deficits, dysphagia.
CVA should be differentiated from transient ischemic attack, which is a related syndrome of stroke symptoms that resolve completely within 24 hours.
CVA or Stroke or cerebrovascular accident: ICD-10 I61.-I64.
ICD-9 434.91
ICD-9-CM states that CVA should be coded as long as the patient is receiving treatment and till the patient is discharged. Once the patient is discharged and for further visits late effect codes of CVA (438 category) should be used.
The late effects of CVA are neurological deficits that persist after initial onset of CVA or may arise at any time later. Some of these condition are
aphasia (inability to speak)
apraxia (altered voluntary movements)
visual field defect
memory deficits or cognitive deficits (involvement of temporal lobe)
hemiplegia or hemiparesis
ataxia
Although aphasia, apraxia, cognitive deficits, hemeplegia, or ataxia are not coded at the time of admission when the patient is diagnosed with CVA, but when the patient presents with these conditions a later date then a code from category 438 should be used to indicate that these are late effects of CVA.
ICD-9-CM proveides a V code V12.54 to indicate history of CVA. Codes from category 438 and CVA should not be assigned at the same visit of date either of these shluld be assigned.
Codes from category 438 can be assigned together with codes from 430-437 when a patient has current CVA and deficits from an old CVA.
In practical cases physicians do not document any relationship between neurological deficits and history CVA in the medical records. So when a patent has hemeplagia and also has a history of CVA codes from 438 catetogy i.e 438.20 are assigned instead of coding history of CVA (V12.54) and hemeplagia (368.10)seperately. The same rule applies to other neurological deficitis such as ataxia, aphasia, cognitive deficits, dysphagia.
ICD 9 Code for Hypertension
ICD 9 Coding for Hypertension
Hypertension, also referred to as high blood pressure, HTN or HPN, is a medical condition in which the blood pressure is chronically elevated.
ICD-9-CM Codes
Category 401 with the following fourth digit classifications
401.0 Malignant
401.1 Benign
401.9 Unspecified
Elevated blood pressure without diagnosis of hypertension is coded to 796.2
ICD 9 Codes for Hypertension and chronic kidney disease
Category 403 of ICD-9-CM is to be used as a combination code for hypertension and chronic kidney disease and the fifth digit describes the stage of the kidney disease.
403.0 Malignant
403.1 Benign
403.9 Unspecified
With fifth digit classifications
0 with chronic kidney disease stage I through stage IV, or unspecified.
1 with chronic kidney disease stage V or end stage renal disease.
Additional code should be used to identify the stage of chronic kidney disease from the category 585 (585.1-585.4, 585.9)
Category 404 Hypertensive heart and chronic kidney disease
When a patient has both hypertensive kidney disease and also hypertensive heart disease then this condition is coded to category 404 with the fifth digit describing the whether there is heart failure associated and also the type of chronic kidney disease as follows:
0 without heart failure and with chronic kidney disease stage I through IV, or unspecified
1 with heart failure and with chronic kidney disease stage I through stage IV, or unspecified
2 without heart failure and with chronic kidney disease stage V or end stage renal disease
3 with heart failure and chronic kidney disease stage V or end stage renal disease
Additional codes are required for the type of heart failure if present and also the stage of chronic kidney disease.
Coding scenarios:
Hypertension + High blood pressure = 401.9 only as high blood pressure is included in 401.9.
Hypertension + Chronic Kidney Disease = 403.90 and 585.9
Hypertension + Chronic Kidney Disease Stage III = 403.90 and 585.3
Hypertension + End Stage Renal Disease(ESRD) = 403.91 and 585.6
Hypertension + Chronic Renal Failure = 403.90 and 585.9
Hypertension + Acute Renal Failure = 401.9 and 584.9
Hypertensive Congestive heart failure + Chronic Renal Failure = 404.91, 428.0, and 585.9
Tags: ICD 9 Code for Hypertension, ICD 9 CM Code for Hypertension
Hypertension, also referred to as high blood pressure, HTN or HPN, is a medical condition in which the blood pressure is chronically elevated.
ICD-9-CM Codes
Category 401 with the following fourth digit classifications
401.0 Malignant
401.1 Benign
401.9 Unspecified
Elevated blood pressure without diagnosis of hypertension is coded to 796.2
ICD 9 Codes for Hypertension and chronic kidney disease
Category 403 of ICD-9-CM is to be used as a combination code for hypertension and chronic kidney disease and the fifth digit describes the stage of the kidney disease.
403.0 Malignant
403.1 Benign
403.9 Unspecified
With fifth digit classifications
0 with chronic kidney disease stage I through stage IV, or unspecified.
1 with chronic kidney disease stage V or end stage renal disease.
Additional code should be used to identify the stage of chronic kidney disease from the category 585 (585.1-585.4, 585.9)
Category 404 Hypertensive heart and chronic kidney disease
When a patient has both hypertensive kidney disease and also hypertensive heart disease then this condition is coded to category 404 with the fifth digit describing the whether there is heart failure associated and also the type of chronic kidney disease as follows:
0 without heart failure and with chronic kidney disease stage I through IV, or unspecified
1 with heart failure and with chronic kidney disease stage I through stage IV, or unspecified
2 without heart failure and with chronic kidney disease stage V or end stage renal disease
3 with heart failure and chronic kidney disease stage V or end stage renal disease
Additional codes are required for the type of heart failure if present and also the stage of chronic kidney disease.
Coding scenarios:
Hypertension + High blood pressure = 401.9 only as high blood pressure is included in 401.9.
Hypertension + Chronic Kidney Disease = 403.90 and 585.9
Hypertension + Chronic Kidney Disease Stage III = 403.90 and 585.3
Hypertension + End Stage Renal Disease(ESRD) = 403.91 and 585.6
Hypertension + Chronic Renal Failure = 403.90 and 585.9
Hypertension + Acute Renal Failure = 401.9 and 584.9
Hypertensive Congestive heart failure + Chronic Renal Failure = 404.91, 428.0, and 585.9
Tags: ICD 9 Code for Hypertension, ICD 9 CM Code for Hypertension
ICD 9 Code for Diabetes
Diabetes mellitus a chronic disease often referred to simply as diabetes is a syndrome of disordered metabolism resulting in abnormally high blood sugar levels due to defects in either insulin secretion or insulin action in the body.
Diabetes develops due to a diminished production of insulin (in type 1) or resistance to its effects (in type 2 and gestational). Both lead to hyperglycemia, which largely causes the acute signs of diabetes: excessive urine production, resulting compensatory thirst and increased fluid intake, blurred vision, unexplained weight loss, lethargy, and changes in energy metabolism.
Diabetes and its treatments can cause many complications. Acute complications (hypoglycemia, ketoacidosis, or nonketotic hyperosmolar coma) may occur if the disease is not adequately controlled. Serious long-term complications include cardiovascular disease (doubled risk), chronic renal failure, retinal damage (which can lead to blindness), nerve damage (of several kinds), and microvascular damage, which may cause erectile dysfunction and poor wound healing. Poor healing of wounds, particularly of the feet, can lead to gangrene, and possibly to amputation.
The term diabetes, without qualification, usually refers to diabetes mellitus, which is associated with excessive sweet urine (known as "glycosuria").
There are two types of Diabetes mellitus type 1 and type 2.
The term "type 1 diabetes" has universally replaced several former terms, including childhood-onset diabetes, juvenile diabetes, and insulin-dependent diabetes (IDDM). Likewise, the term "type 2 diabetes" has replaced several former terms, including adult-onset diabetes, obesity-related diabetes, and non-insulin-dependent diabetes (NIDDM).
In type 1 diabetes without insulin, diabetic ketoacidosis often develops which may result in coma or death.
Gestational diabetes mellitus (GDM) resembles type 2 diabetes in several respects. It occurs in about 2%–5% of all pregnancies and may improve or disappear after delivery.
ICD-9-CM Codes
Category 250 Diabetes mellitus
Fifth digit classifications for category 250
250.00 type II or unspecified type, not stated as uncontrolled
Fifth-digit 0 is for use for type II patients, even if the patient requires insulin
250.01 type I [juvenile type], not stated as uncontrolled
250.02 type II or unspecified type, uncontrolled
Fifth-digit 2 is for use for type II patients, even if the patient requires insulin
250.03 type I [juvenile type], uncontrolled
Complications of diabetes and subcategories of category 250
250.0 Diabetes mellitus without mention of complication
250.1 Diabetes with ketoacidosis
250.2 Diabetes with hyperosmolarity
250.4 Diabetes with renal manifestations
250.5 Diabetes with ophthalmic manifestations
250.6 Diabetes with neurological manifestations
250.7 Diabetes with peripheral circulatory disorders
250.8 Diabetes with other specified manifestations
250.9 Diabetes with unspecified complication
In case of type II diabetes if the patient is on insulin than V58.67 is used for associated long-term (current) insulin use (V58.67)
Coding scenarios
Hyperglycemia + Diabetes = 250.00 as hyperglycemia is symptom of diabetes
Hypoglycemia + Diabetes = 250.80
Diabetic foot = 250.80 + foot condition
CPT procedures associated with diabetes
82962 - Fasting blood suger
ICD 9 Code for Diabetes, ICD 9 Code for Diabetes, ICD 9 Code for Diabetes
Diabetes develops due to a diminished production of insulin (in type 1) or resistance to its effects (in type 2 and gestational). Both lead to hyperglycemia, which largely causes the acute signs of diabetes: excessive urine production, resulting compensatory thirst and increased fluid intake, blurred vision, unexplained weight loss, lethargy, and changes in energy metabolism.
Diabetes and its treatments can cause many complications. Acute complications (hypoglycemia, ketoacidosis, or nonketotic hyperosmolar coma) may occur if the disease is not adequately controlled. Serious long-term complications include cardiovascular disease (doubled risk), chronic renal failure, retinal damage (which can lead to blindness), nerve damage (of several kinds), and microvascular damage, which may cause erectile dysfunction and poor wound healing. Poor healing of wounds, particularly of the feet, can lead to gangrene, and possibly to amputation.
The term diabetes, without qualification, usually refers to diabetes mellitus, which is associated with excessive sweet urine (known as "glycosuria").
There are two types of Diabetes mellitus type 1 and type 2.
The term "type 1 diabetes" has universally replaced several former terms, including childhood-onset diabetes, juvenile diabetes, and insulin-dependent diabetes (IDDM). Likewise, the term "type 2 diabetes" has replaced several former terms, including adult-onset diabetes, obesity-related diabetes, and non-insulin-dependent diabetes (NIDDM).
In type 1 diabetes without insulin, diabetic ketoacidosis often develops which may result in coma or death.
Gestational diabetes mellitus (GDM) resembles type 2 diabetes in several respects. It occurs in about 2%–5% of all pregnancies and may improve or disappear after delivery.
ICD-9-CM Codes
Category 250 Diabetes mellitus
Fifth digit classifications for category 250
250.00 type II or unspecified type, not stated as uncontrolled
Fifth-digit 0 is for use for type II patients, even if the patient requires insulin
250.01 type I [juvenile type], not stated as uncontrolled
250.02 type II or unspecified type, uncontrolled
Fifth-digit 2 is for use for type II patients, even if the patient requires insulin
250.03 type I [juvenile type], uncontrolled
Complications of diabetes and subcategories of category 250
250.0 Diabetes mellitus without mention of complication
250.1 Diabetes with ketoacidosis
250.2 Diabetes with hyperosmolarity
250.4 Diabetes with renal manifestations
250.5 Diabetes with ophthalmic manifestations
250.6 Diabetes with neurological manifestations
250.7 Diabetes with peripheral circulatory disorders
250.8 Diabetes with other specified manifestations
250.9 Diabetes with unspecified complication
In case of type II diabetes if the patient is on insulin than V58.67 is used for associated long-term (current) insulin use (V58.67)
Coding scenarios
Hyperglycemia + Diabetes = 250.00 as hyperglycemia is symptom of diabetes
Hypoglycemia + Diabetes = 250.80
Diabetic foot = 250.80 + foot condition
CPT procedures associated with diabetes
82962 - Fasting blood suger
ICD 9 Code for Diabetes, ICD 9 Code for Diabetes, ICD 9 Code for Diabetes
ICD 9 Code for Asthma
Asthma is a lung condition in in which the airways constrict, become inflamed, and are lined with excessive amounts of mucus, often in response to one or more triggers like tobacco smoke, allegen.
Symptoms: The airway narrowing causes symptoms such as wheezing, shortness of breath, chest tightness, and coughing. The airway constriction responds to bronchodilators.
An acute exacerbation of asthma is commonly referred to as an asthma attack.
Severe asthma attacks, which may not be responsive to standard treatments is called status asthmaticus.
Symptomatic control of episodes of wheezing and shortness of breath is generally achieved with bronchodilators which are typically provided in pocket-sized, metered-dose inhalers (MDIs).
A spacer is a plastic cylinder that mixes the medication with air in a simple tube, making it easier for patients to receive a full dose of the drug and allows for the active agent to be dispersed into smaller, more fully inhaled bits.
A nebulizer which provides a larger, continuous dose can also be used. Nebulizers work by vaporizing a dose of medication in a saline solution into a steady stream of foggy vapour, which the patient inhales continuously until the full dosage is administered.
ICD-9-CM Codes
Asthma: 493.90 for age > 17
493.00 for age <=17
with followinf fifth digits specifications
0: Unspecified
1: Status Asthmaticus
2: Exacerbation
Bronchitis(chronic) is part of Asthma so bronchitis(chronic) is not coded when a patient has Asthma.
Asthma + Bronchitis = 493.90 (No need of 490.0 chronic bronchitis)
Although, acute bronchitis should be reported sperratly.
Asthma + Acute bronchitis: 493.90 and 466.0
There are combination codes for asthma and CPOD
Asthma + CPOD= 493.20
Asthma + CPOD exacerbation = 493.22
Bronchospasm is a symptoms of Asthma and is not coded along with asthma
ICD 9 Code for Asthma, ICD 9 Code for Asthma, ICD 9 Code for Asthma
Symptoms: The airway narrowing causes symptoms such as wheezing, shortness of breath, chest tightness, and coughing. The airway constriction responds to bronchodilators.
An acute exacerbation of asthma is commonly referred to as an asthma attack.
Severe asthma attacks, which may not be responsive to standard treatments is called status asthmaticus.
Symptomatic control of episodes of wheezing and shortness of breath is generally achieved with bronchodilators which are typically provided in pocket-sized, metered-dose inhalers (MDIs).
A spacer is a plastic cylinder that mixes the medication with air in a simple tube, making it easier for patients to receive a full dose of the drug and allows for the active agent to be dispersed into smaller, more fully inhaled bits.
A nebulizer which provides a larger, continuous dose can also be used. Nebulizers work by vaporizing a dose of medication in a saline solution into a steady stream of foggy vapour, which the patient inhales continuously until the full dosage is administered.
ICD-9-CM Codes
Asthma: 493.90 for age > 17
493.00 for age <=17
with followinf fifth digits specifications
0: Unspecified
1: Status Asthmaticus
2: Exacerbation
Bronchitis(chronic) is part of Asthma so bronchitis(chronic) is not coded when a patient has Asthma.
Asthma + Bronchitis = 493.90 (No need of 490.0 chronic bronchitis)
Although, acute bronchitis should be reported sperratly.
Asthma + Acute bronchitis: 493.90 and 466.0
There are combination codes for asthma and CPOD
Asthma + CPOD= 493.20
Asthma + CPOD exacerbation = 493.22
Bronchospasm is a symptoms of Asthma and is not coded along with asthma
ICD 9 Code for Asthma, ICD 9 Code for Asthma, ICD 9 Code for Asthma
Medical coding
Medical coding is one of the fastest growing profession and there is still shortage of coding professionals. This industry is poised to grow rapidly for the next 20-30 years due to ageing population and increasing health care needs. Currently US is still using ICD-9-CM whereas some of the countries have shifted to ICD-10-CM. The US may implement ICD-10-CM from 2013. ICD-10-CM will make the job of the coding professionals more difficult as the number of codes and procedures
Subscribe to:
Posts (Atom)
