THE CODING EDGE® ARCHIVES

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Procedure Practice 09/15/98 - Feature Article 09/15/98
   

Procedure Practice 09/15/98:
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 this episode of treatment. 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

  

Diagnoses

The physician states that the patient has bilateral senile cataracts. In the Disease Index under the entry for cataract, senile, the coder is directed to 366.10. The entry in the Tabular List verifies that 366.10 is the correct diagnosis code: Senile cataract, unspecified.
  

Procedure

The surgeon performed hydrodissection and phacoemulsification to remove the cataract, followed by implantation of an intraocular lens. In the ICD-9-CM Procedure Index, the coder finds 13.41 under the heading "Extraction, cataract, extracapsular approach, phacoemulsification (ultrasonic) (with aspiration)." The entry in the Tabular List verifies that 13.41 is the correct procedure code: Extracapsular extraction of lens by phacoemulsification and aspiration of cataract. This code correctly identifies the first half of the procedure. The coder also needs to code the intraocular lens insertion. In the Procedure Index under the entry for "Insertion, lens, prosthetic (intraocular) with cataract extraction, one-stage," the coder is directed to 13.71. The definition of 13.71 in the Tabular List confirms that it is the correct procedure code: Insertion of prosthetic lens (pseudophakos) at time of cataract extraction…

The correct CPT-4 procedure code for ECCE with IOL insertion is 66984, Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsfication).

Procedure Practice 09/15/98 - Feature Article 09/15/98
Bibliography - References:
Coder’s Desk Reference, Medicode Publishing, Salt Lake City, UT.
Code It Right, Medicode Publishing, Salt Lake City, UT
CPT 98 Physicians’ Current Procedural Terminology, American Medical Association, Chicago, IL.
St. Anthony’s Illustrated ICD-9-CM Code Book, St. Anthony’s Publishing, Reston, VA.
ICD-9-CM Coding Clinic, May-June 1985, American Hospital Association, Chicago, IL.		 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.