AS I SEE IT


ters should be reviewed by both the physician and the facility. For addi- tional information, see ICD-10-CM 2014 Manual Section 1 Conventions, general coding guidelines and chapter specific guidelines C. Chapter-Specific Coding Guidelines 19. Injury, Poison- ing, and Certain Other Consequences of External Causes and other chap- ter-specific guidelines for specific 7th character definitions.


Gastroenterology Polyp of Colon. While ICD-10 includes a “not otherwise specified” diagno- sis code for “polyp of colon,” this code should be used rarely since the surgeon knows the location of the polyp. The surgeon will need to specify the ana- tomical location (e.g., cecum, trans- verse, etc.). While not an all-inclusive mapping, potential codes include but are not limited to the following: ■


Benign neoplasm of cecum ■ Benign neoplasm of appendix


■ Benign neoplasm of ascending colon ■ Benign neoplasm of transverse colon ■ Benign neoplasm of descending colon ■ Benign neoplasm of sigmoid colon ■ Benign neoplasm of colon, unspecified ■ Polyp of Colon


Hemorrhoids The


documentation must differen-


tiate between 1st, 2nd, 3rd and 4th degree hemorrhoids. ICD-10 code series (K64.-) provides the clarifica- tion between the degrees. The physician must determine and clarify the degree based on this information, not the coder. The coder should never be put in a posi- tion of practicing medicine. Diverticulosis and diverticuli- tis must be documented as “with” or “without” perforation or abscess as well as “with” or “without” bleed- ing. Examples of potential code assignment(s) include but are not lim- ited to the following: ■


■ ■ ■ ■


Diverticulosis of large intestine w/o perforation or abscess w/o bleeding


Diverticulosis of large intestine w/o perforation or abscess with bleeding


Diverticulitis of large intestine w/o perforation or abscess w/o bleeding


Diverticulitis of large intestine w/o perforation or abscess with bleeding


Pain Management


Laterality is required when appli- cable and is documented within the diagnosis descriptor. Spinal regions are further subdi-


vided, for example: ■


Cervical


■ High cervical region ■ Mid-cervical region ■ Cervicothoracic region ■ Thoracic region


■ Thoracolumbar region ■ Lumbar region ■


Diverticulitis of large intestine with perforation and abscess with bleeding


Lumbosacral region The physician will need to be specific with conditions affecting the lumbar ver- sus lumbosacral regions which, in ICD- 9, was reported as lumbosacral due to


lack of specificity. ICD-10 also provides clarification for high-cervical, mid-cer- vical and cervicothoracic regions. Diagnoses are further defined pending the condition to include com- bination codes. For example, while an ICD-9 code may be reported as 721.3 for Lumbosacral spondylosis with- out myelopathy, ICD-10 mapping and options include but are not limited to the following: ■


Other spondylosis w/radiculopathy, lumbar region


■ ■ ■ ■ ■


Other spondylosis w/radiculopathy, lumbosacral region


Other spondylosis w/radiculopathy, sacral/sacrococcygeal region


Spondylosis w/o myelopathy or radic- ulopathy, lumbar region


Spondylosis w/o myelopathy or radic- ulopathy, lumbosacral region


Spondylosis w/o myelopathy or radic- ulopathy, sacral/sacrococcygeal region ■ Other spondylosis, lumbar region ■ Other spondylosis, lumbosacral region ■


Other spondylosis, sacral and sacro- coccygeal region


ASC FOCUS JUNE/JULY 2014 9


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38