THE CODING EDGE® ARCHIVES

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Procedure Practice 04/15/99 - Feature Article 04/15/99
   

Procedure Practice 04/15/99:
Coding Recommendations

  
Listed below are the ICD-9-CM diagnosis and procedure codes as well as the CPT-4 procedure codes that we think properly classify the treatment described. Please note that modifiers, used only for physician billing purposes, have not been assigned to the CPT-4 codes. If you disagree with our suggestions or have other comments, please send an e-mail to codingedge@lagunamedsys.com.
   

Suggested Codes and Rationale
   

Diagnosis Codes

The patient has end-stage renal disease due to hypertensive nephropathy. In the Index to Diseases under "failure, renal, with hypertension" the coder is referred to 403.91. The entry in the Tabular List confirms that 403.91 correctly identifies this diagnosis, Hypertensive renal disease, unspecified…includes hypertensive nephropathy and renal failure…
  

ICD-9-CM Procedure Codes

The surgeon performed a percutaneous central catheter placement for hemodialysis.

As discussed in our coding tips, percutaneous CVC placement for renal dialysis is coded 38.95, Venous catheterization for renal dialysis.
  

CPT-4 Procedure Codes

The CPT-4 procedure code is dependent upon the placement technique used and the patient's age. The fact that the catheter will be used for hemodialysis does not affect code assignment. The operative report shows that the 53-year-old patient had a percutaneous catheter placement. The correct CPT-4 procedure code is 36489, Placement of central venous catheter (subclavian, jugular, or other vein) (eg for central venous pressure, hyperalimentation, hemodialysis, or chemotherapy); percutaneous, over age 2.

   

Procedure Practice 04/15/99 - Feature Article 04/15/99

Bibliography - References:
Coding Clinic for ICD-9-CM, third quarter 1991; American Hospital Association, Chicago, IL.
CPT Assistant, Feb. 1999, American Medical Association, Chicago, IL.
Current Procedural Terminology CPT 1999, American Medical Association, Chicago, IL
St. Anthony’s HCPCS Report, Oct. 92, Nov. 95, and Jun. 97, St. Anthony Publishing, Reston, VA.
St. Anthony's Illustrated ICD-9-CM Code Book, St, Anthony Publishing, Reston, VA.		 Notice: This part of our web site was prepared to assist in understanding and maintaining good coding skills. For proper use of this feature, reference must be made to official coding guidelines when necessary. The information here presented is only to be used as a supplement to those guidelines. Laguna Medical Systems, Inc., makes no representations or guarantees as to amounts that will be paid by Medicare or other third party payers.

 

Please be aware that the Coding Edge® Archive pages are NOT retroactively updated
to reflect possible coding rules and regulation changes made after the publishing date.