Anesthesia Cross Coder. Essential links from CPT codes to ICD-9-CM and HCPCS codes

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1 Anesthesia Cross Coder Essential links from CPT codes to ICD-9-CM and HCPCS codes 2015

2 Contents Introduction... i CPT Anesthesia to Procedure Crosswalk...i Format...i Icon Key...ii CPT Codes...ii Resequenced Codes...iii Physicians and Other Qualified Health Care Professional...iii Code Links...iii ICD-9-CM Diagnostic Codes...iv ICD-9-CM to ICD-10 Transition...v ICD-9-CM Procedure Codes...v ICD-9-CM Volume 3 to ICD-10-PCS Transition..vi HCPCS Level II Codes...vi Modifiers...vi Summary...vi CPT Procedure to Anesthesia Code... 1 Head Neck Thorax (Chest Wall and Shoulder Girdle) Intrathoracic Spine and Spinal Cord Upper Abdomen Lower Abdomen Perineum Pelvis (Except Hip) Upper Leg (Except Knee) Knee and Popliteal Area Lower Leg (Below Knee, Includes Ankle and Foot) Shoulder and Axilla Upper Arm and Elbow Forearm, Wrist, and Hand Radiological Procedures Burn Excisions or Debridement Obstetric Other Procedures Introduction/Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Moderate (Conscious) Sedation Appendixes Modifiers Glossary Crosswalks 2014 OptumInsight, Inc. CPT 2013 American Medical Association. All Rights Reserved.

3 Introduction Optum is pleased to present the 2013 Anesthesia Cross Coder. Fully comprehensive, the Anesthesia Cross Coder links more than 300 CPT codes commonly used by anesthesiologists to corresponding surgical CPT and ICD-9-CM diagnosis codes, and as appropriate, ICD-9-CM procedure and HCPCS Level II codes. Optum believes that professional coders working in physician offices, clinical outpatient areas, hospitals, as well as payer settings will find this reference a useful tool. Anesthesia Cross Coder is based on the Anesthesia section of Physicians Current Procedural Terminology (CPT ), but includes CPT codes commonly used by practicing anesthesiologists from other sections of the CPT system as well. Up-to-date CPT codes link to the following related medical coding systems: International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) Healthcare Common Procedure Coding System (HCPCS) Level II All coding relationships in Anesthesia Cross Coder start with the Anesthesia section of the CPT book presenting a general clinical picture of each anesthesia code. Pertinent surgical related coding relationships were carefully reviewed and screened for appropriate information. In some instances, the data is abridged simply due to the enormity of the listings. For example, diagnosis codes for infections call for additional codes to identify specific organisms. The possible associations are too numerous and do not appear in Anesthesia Cross Coder. In a similar vein, Anesthesia Cross Coder features codes that require accompanying etiologies or manifestations (e.g., Code first underlying disease ). However, associated infectious and parasitic diseases are, once again, simply too numerous to list and do not appear in Anesthesia Cross Coder. For further discussion on secondary diagnosis codes, see the ICD-9-CM section later in this introduction. Some CPT codes are omitted from the listing because consistent and reliable cross-links are almost impossible to establish. Unlisted procedure codes are an obvious example. As a coding reference, Anesthesia Cross Coder presents most likely scenarios as derived from clinical information and official sources. Anesthesia Cross Coder is not a substitute for ICD-9-CM or any other medical coding reference and users are urged to regularly consult all available sources. The absence of any specific code does not necessarily indicate that its association to the base procedure code is inappropriate. Assuming all rules of anesthesia coding are followed, excepted diagnosis codes may prove appropriate to a specific code scenario. Anesthesia Cross Coder does not include coding rules or guidelines. Once again, the user is urged to consult the original coding reference (e.g., CPT, ICD-9-CM, HCPCS Level II, etc.) or one of several reputable medical coding instruction manuals. CPT Anesthesia to Procedure Code Crosswalk The surgical CPT codes are listed with the corresponding anesthesia CPT codes. The relationships were developed by comparing each individual surgical CPT code, current practice patterns, and techniques to determine the appropriate relationship of the surgical code to the anesthesia CPT code assignment. Using this methodology, the surgical codes and anesthesia codes are assigned the most appropriate coding relationships. Optum does not rely on the combinations suggested by other organizations or groups with the exception of CMS. Reimbursement data was not used to suggest one code combination over another. Format An understanding of the Anesthesia Cross Coder format allows users to easily navigate its content. Information within the main section ties to the CPT book and the codes are presented in the same numeric order as the anesthesia and other appropriate CPT sections. Sections Anesthesia Cross Coder provides linked information to the CPT code range to 01999, as well as several other code ranges typically used by anesthesiologists. The codes are divided into the same sections as found in the CPT book. Codes and Code Ranges The data within each CPT code set of Anesthesia Cross Coder is presented as follows: Anesthesia CPT code Corresponding surgical CPT codes and descriptions ICD-9-CM diagnostic codes and descriptions ICD-9-CM procedural codes and descriptions, where applicable HCPCS Level II codes and descriptions, where applicable Crosswalks 201 OptumInsight, Inc. CPT 201 American Medical Association. All Rights Reserved. i

4 CPT Procedure to Anesthesia Code 0051T 0052T 0053T 0071T 0072T 0073T 0075T T T T 0100T T T T 0169T T 0182T 0184T 0191T 0192T 0195T 0200T 0201T 0202T 0219T T T 0226T 0227T 0234T 0235T 0236T 0237T T T 0246T 0247T 0248T 0249T 0253T 0254T 0255T 0262T T T T 0267T 0268T 0269T 0270T 0271T 0274T 0275T 0281T 0282T 0283T 0284T 0288T 0293T 0294T 0299T T 0303T 0304T 0307T 0308T T T T T 0316T 0318T T 0320T 0321T 0322T 0323T 0324T 0325T 0326T OptumInsight, Inc. CPT 2013 American Medical Association. All Rights Reserved. 4

5 Lower Leg (Below Knee, Includes Ankle and Foot) Anesthesia for all closed procedures on lower leg, ankle, and foot Associated CPT Codes 0299T Extracorporeal shock wave for integumentary wound healing, high energy, including topical application and dressing care; initial wound Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs) Aspiration and injection for treatment of bone cyst Removal, under anesthesia, of external fixation system Ablation, bone tumor(s) (eg, osteoid osteoma, metastasis) radiofrequency, percutaneous, including computed tomographic guidance Injection procedure for ankle arthrography Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, tibia Closed treatment of tibial shaft fracture (with or without fibular fracture); without Closed treatment of tibial shaft fracture (with or without fibular fracture); with, with or without skeletal traction Percutaneous skeletal fixation of tibial shaft fracture (with or without fibular fracture) (eg, pins or screws) Closed treatment of medial malleolus fracture; without Closed treatment of medial malleolus fracture; with, with or without skin or skeletal traction Closed treatment of posterior malleolus fracture; without Closed treatment of posterior malleolus fracture; with Closed treatment of proximal fibula or shaft fracture; without Closed treatment of proximal fibula or shaft fracture; with Closed treatment of distal fibular fracture (lateral malleolus); without Closed treatment of distal fibular fracture (lateral malleolus); with Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); without Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); with Closed treatment of trimalleolar ankle fracture; without Closed treatment of trimalleolar ankle fracture; with Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; without Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; with skeletal traction and/or requiring Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation Manipulation of ankle under general anesthesia (includes application of traction or other fixation apparatus) Closed treatment of calcaneal fracture; without Closed treatment of calcaneal fracture; with Percutaneous skeletal fixation of calcaneal fracture, with Closed treatment of talus fracture; without Closed treatment of talus fracture; with Percutaneous skeletal fixation of talus fracture, with Treatment of tarsal bone fracture (except talus and calcaneus); without, each Treatment of tarsal bone fracture (except talus and calcaneus); with, each Percutaneous skeletal fixation of tarsal bone fracture (except talus and calcaneus), with, each Closed treatment of metatarsal fracture; without, each Closed treatment of metatarsal fracture; with, each Percutaneous skeletal fixation of metatarsal fracture, with, each Closed treatment of fracture great toe, phalanx or phalanges; without Closed treatment of fracture great toe, phalanx or phalanges; with Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with Closed treatment of fracture, phalanx or phalanges, other than great toe; without, each Closed treatment of fracture, phalanx or phalanges, other than great toe; with, each Closed treatment of sesamoid fracture Closed treatment of tarsal bone dislocation, other than talotarsal; requiring anesthesia Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, with Closed treatment of talotarsal joint dislocation; requiring anesthesia Percutaneous skeletal fixation of talotarsal joint dislocation, with Closed treatment of tarsometatarsal joint dislocation; requiring anesthesia Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with Closed treatment of metatarsophalangeal joint dislocation; requiring anesthesia Percutaneous skeletal fixation of metatarsophalangeal joint dislocation, with Closed treatment of interphalangeal joint dislocation; requiring anesthesia Percutaneous skeletal fixation of interphalangeal joint dislocation, with Extracorporeal shock wave, high energy, performed by a physician or other qualified health care professional, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia Strapping; ankle and/or foot Strapping; toes Strapping; Unna boot Application of multi-layer compression system; leg (below knee), including ankle and foot Application of multi-layer compression system; thigh and leg, including ankle and foot, when performed ICD-9-CM Diagnostic Malignant neoplasm of long bones of lower limb Malignant neoplasm of short bones of lower limb Secondary malignant neoplasm of bone and bone marrow Benign neoplasm of long bones of lower limb Benign neoplasm of short bones of lower limb Neoplasm of uncertain behavior of bone and articular cartilage Neoplasms of unspecified nature of bone, soft tissue, and skin Unspecified disorder of calcium metabolism (Use additional code to identify any associated intellectual disabilities) Hypercalcemia (Use additional code to identify any associated intellectual disabilities) Other disorders of calcium metabolism (Use additional code to identify any associated intellectual disabilities) Osteoarthrosis, unspecified whether generalized or localized, ankle and foot Loose body in ankle and foot joint Ankylosis of ankle and foot joint Developmental dislocation of joint, lower leg Developmental dislocation of joint, ankle and foot Effusion of ankle and foot joint 2 Unspecified code E Manifestation code 2014 OptumInsight, Inc. 372 ; Female diagnosis : Male diagnosis CPT 2013 American Medical Association. All Rights Reserved.

CROSS CODER. Sample page. Anesthesia. codes to ICD-10-CM and HCPCS. Essential links from CPT. Power up your coding optum360coding.

CROSS CODER. Sample page. Anesthesia. codes to ICD-10-CM and HCPCS. Essential links from CPT. Power up your coding optum360coding. CROSS CODER 2019 Anesthesia Essential links from CPT codes to ICD-10-CM and HCPCS Power up your coding optum360coding.com Contents Introduction...i CPT Anesthesia to Procedure Code Crosswalk... i Format...