Medtronic Coronary and Peripheral Vascular ICD-10 … 2015 Medtronic Coronary and Peripheral...

May 2015

Medtronic Coronary and Peripheral Vascular

ICD-10 Coding for Hospitals

10204027DOC Rev 1A

2

DisclaimerReimbursement information provided by Medtronic is for illustrative purposes only and does not constitute legal advice.

Information provided is gathered from third party sources and is subject to change without notice due to frequently changing laws, rules and regulations. Medtronic makes no guarantee that the use of this information will prevent differences of opinion or disputes with Medicare or other third party payers as to the correct form of billing or the amount that will be paid to providers of service.

The provider of service has the responsibility to determine medical necessity and to submit appropriate codes and charges for care provided. Please contact your local payers, reimbursement specialists and/or legal counsel for interpretation of coding, coverage, and payment policies.

Medtronic does not promote the use of its products outside FDA-approved labeling.

10204027DOC Rev 1A

3

ICD-10-PCS Procedure Codes

ICD-10-CM Diagnosis Codes

Background and Framework

Topics

Appendix : Key Resources

DRG Impact

Attachment : Diagnosis Code Crosswalks

Questions

10204027DOC Rev 1A

Background and Framework

4 10204027DOC Rev 1A

5

Effective Date

ICD-10 goes into effect October 1, 2015.

ICD-10-CM for diagnosis codes and ICD-10-PCS for procedure codes go into effect together on the same date.

ICD-10 is effective by date of discharge, not by date of admission.

Use of ICD-10 in the United States was formally proposed in August 2008 and finalized in January 2009.

Implementation of ICD-10 was initially scheduled for October 2013 and has been postponed twice since then.

10204027DOC Rev 1A

6

Who Uses What

Provider Setting Diagnoses Procedures

Hospitals Inpatient ICD-10-CM ICD-10-PCS

Hospitals Outpatient ICD-10-CM CPT

Physicians Facility/Office ICD-10-CM CPT

ASCs Outpatient ICD-10-CM CPT

Hospitals, physicians and all other providers must use ICD-10 diagnosis codes.

Hospitals must also use ICD-10-PCS procedure codes for inpatient cases.

Implementation of ICD-10 does not affect use of CPT.

10204027DOC Rev 1A

7

ICD-10 Coding Guidelines

Guidelines for use of ICD-10 are available from multiple credible sources.

The ICD-10 Official Guidelines for Coding and Reporting

Instructions within the ICD-10 codebook itself

Coding Clinic and AHA Coding Clinic Advisor

Minutes from meetings of the ICD-10 Coordination and Maintenance Committee

AHA ICD-10-CM and ICD-10-PCS Coding Handbook

AHIMA ICD-10-PCS: An Applied Approach

ICD-10-PCS Reference Manual

10204027DOC Rev 1A

8

General Equivalence MappingsGeneral Equivalence Mappings (GEMs) are a useful tool for going back-and-forth between ICD-9 and ICD-10 codes, for both diagnoses and procedures.

Forward GEMs go from ICD-9 to ICD-10; Backward GEMs go from ICD-10 to ICD-9.

The GEMs can be found at: http://www.cdc.gov/nchs/icd/icd10cm.htm#icd2105

GEMs can be a good starting place. But NCHS and CMS strongly recommend coding directly from the ICD-10 codebooks, as studies have consistently indicated that this is most accurate.

http://www.cms.gov/Medicare/Coding/ICD10/2015-ICD-10-CM-and-GEMs.html

10204027DOC Rev 1A

ICD-10-CM Diagnosis Codes

9 10204027DOC Rev 1A

10

Codes are organized by chapter, mostly by body system. The chapters are virtually identical to those in ICD-9-CM.

Codes are alpha-numeric and can be 3 to 7 digits long.

Salpha

2number

5alpha or number

1 x A

Category Details Extension

0S25.00xAMinor laceration of thoracic aorta, initial encounter

I 7 0

1I70.1Atherosclerosis of renal artery

Z 9 8

6Z98.61Coronary angioplasty status1

Decimal

Diagnosis Code Structure

10204027DOC Rev 1A

11

Volume of Diagnosis CodesICD-9-CM

14,567 codesICD-10-CM

69,823 codes

ICD-10-CM has far more diagnosis codes than ICD-9-CM and provides a greater level of specificity.

Example: Atherosclerosis of native arteries of extremity with gangrene ICD-9-CM ICD-10-CM

440.24

Atherosclerosis of native arteries of extremities, with gangrene

I70.261 Atherosclerosis, native arteries of extremities, with gangrene , right leg I70.262 Atherosclerosis, native arteries of extremities, with gangrene, left leg I70.263 Atherosclerosis, native arteries of extremities, with gangrene, bilateral legs I70.268 Atherosclerosis, native arteries of extremities, with gangrene, other extremityI70.269 Atherosclerosis, native arteries of extremities, with gangrene, unspecified extremity

ICD-9-CM ICD-10-CM

433.10

Occlusion and stenosis of carotid artery without mention of cerebral infarction

I65.21 Occlusion and stenosis of right carotid artery, not resulting in cerebral infarction I65.22 Occlusion and stenosis of left carotid artery, not resulting in cerebral infarction

I65.23 Occlusion and stenosis of bilateral carotid arteries, not resulting in cerebral infarction

I65.29 Occlusion and stenosis of unspecified carotid artery, not resulting in cerebral infarction

Example: Carotid artery stenosis

10204027DOC Rev 1A

12

Angina and Coronary Artery Disease Angina codes (I20) are not assigned separately if the patient also has

CAD. A combination code is used instead.

A cause-and-effect relationship between angina and CAD can be assumed.1

1. ICD-10-CM Official Guidelines for Coding and Reporting (Diagnoses), FY 2015, p.42

Does the patient also have angina?

What kind of vessel has coronary atherosclerosis?

What kind of angina?

To code CAD in ICD-10-CM, the coder must know three things:

Code Description Notes

I25.10 Atherosclerotic heart disease of native coronary artery without angina pectoris Use for CAD or ASHD NOS without angina

I25.119 Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris Use for CAD or ASHD NOS with angina

I25.709 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectoris Use for CAD or ASHD with CABG with angina

10204027DOC Rev 1A

13

Atherosclerosis of Extremity A single code identifies the site of ulcer. A separate code is assigned

for severity of ulcer. ICD-9-CM ICD-10-CM

440.23

Atherosclerosis of native arteries of extremities, with ulceration

I70.231 Atherosclerosis, native arteries of right leg with ulceration of thighI70.232 Atherosclerosis, native arteries of right leg with ulceration of calfI70.233 Atherosclerosis, native arteries of right leg with ulceration of ankleI70.234 Atherosclerosis, native arteries of right leg with ulceration of heel and midfootI70.235 Atherosclerosis, native arteries of right leg with ulceration of other part of footI70.238 Atherosclerosis, native arteries of right leg with ulceration of other part of lower right leg I70.239 Atherosclerosis, native arteries of right leg with ulceration of unspecified site

Codes for atherosclerosis of bypass graft identify the type of graft, as well as laterality, manifestations, and site of ulceration.

ICD-10-CM Used when atherosclerosis is present in a bypass graft and …

I70.3~~ Atherosclerosis of unspecified type of bypass graft of extremities The type of bypass graft is not documented or not known

I70.4~~ Atherosclerosis of autologous vein bypass graft of extremities

The bypass graft is composed of a vein harvested from the patient’s body, eg, saphenous vein

170.5~~ Atherosclerosis of nonautologous biological bypass graft of extremities The bypass graft is composed of a cadaveric vessel

I70.6~~ Atherosclerosis of nonbiological bypass graft of extremities

The bypass graft is composed of Gore-Tex or another synthetic material - new classification

I70.7~~ Atherosclerosis of other type of bypass graft of extremities

The composition of the bypass graft is specified but none of the above, eg. an autologous artery – new classification

10204027DOC Rev 1A

14

ICD-9-CM410.0x Acute myocardial infarction, of anterolateral wall 410.1x Acute myocardial infarction, of other anterior wall 410.2x Acute myocardial infarction, of inferolateral wall410.3x Acute myocardial infarction, of inferoposterior wall410.4x Acute myocardial infarction, of other inferior wall 410.5x Acute myocardial infarction, of other lateral wall410.6x Acute myocardial infarction, true posterior wall 410.7x Acute myocardial infarction, subendocardial (NSTEMI)410.8x Acute myocardial infarction, of other specified sites 410.9x Acute myocardial infarction, unspecified site

Acute Myocardial Infarction

AMI: ICD-9-CM

AMI: ICD-10-CM Episode of care is not identified per se. AMI is differentiated between initial AMI (I21) and subsequent AMI (I22). The AMI site identifies the specific coronary artery involved (“culprit

lesion”).

ICD-10-CM handles acute myocardial infarction differently from ICD-9-CM.

5th digit

0 – unspecified episode of care

1 – initial episode of care

2 – subsequent episode of care

10204027DOC Rev 1A

15

Initial AMI (I21)


ICD-10-CMI21.01 ST elevation (STEMI) myocardial infarction involving left main coronary arteryI21.02 ST elevation (STEMI) myocardial infarction involving left anterior descending coronary arteryI21.09 ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall I21.11 ST elevation (STEMI) myocardial infarction involving right coronary arteryI21.19 ST elevation (STEMI) myocardial infarction involving other coronary arteryI21.21 ST elevation (STEMI) myocardial infarction involving left circumflex coronary arteryI21.29 ST elevation (STEMI) myocardial infarction involving other sitesI21.3 ST elevation (STEMI) myocardial infarction of unspecified site I21.4 Non-ST elevation (NSTEMI) myocardial infarction

Initial AMI codes I21 continue to be assigned to encounters for continued care, including transfer to another hospital or post-acute setting, while the AMI is within 28 days of onset.2

If the AMI is documented as NSTEMI (subendocardial, non-transmural) and a site is provided, it is still coded as NSTEMI.3

2. ICD-10-PCS Official Guidelines for Coding and Reporting (Diagnosis), FY 2015, Section I, C9.e(1 )3. ICD-10-PCS Official Guidelines for Coding and Reporting (Diagnosis), FY 2015, Section I, C9.e(3 )

10204027DOC Rev 1A

16


ICD-10-CMI22.0 Subsequent ST elevation (STEMI) myocardial infarction of anterior wallI22.1 Subsequent ST elevation (STEMI) myocardial infarction of inferior wallI22.2 Subsequent non-ST elevation (NSTEMI) myocardial infarctionI22.8 Subsequent ST elevation (STEMI) myocardial infarction of other sitesI22.9 Subsequent ST elevation (STEMI) myocardial infarction of unspecified site

Subsequent AMI (I22)

A subsequent AMI is a new AMI that occurs within 28 days of a previous AMI, regardless of site.4

Codes from I22 cannot be assigned alone. They must always be assigned with a code from I21. Sequencing of the codes depends on the circumstances of the encounter.4

4. ICD-10-PCS Official Guidelines for Coding and Reporting (Diagnosis), FY 2015, Section I, C9.e(4 )

10204027DOC Rev 1A

17

Device Complications

ICD-9-CM ICD-10-CM

996.72 Other complication due to other cardiac device, implant and graft T82.857A Stenosis of cardiac prosthetic devices, implants

and grafts, initial encounter

996.74 Other complication due to other vascular device , implant and graft T82.858A Stenosis of vascular prosthetic devices, implants

and grafts, initial encounter

For mechanical complication, ICD-10-CM differentiates certain types of complication and specifies certain devices.

For other complications, ICD-10-CM differentiates the type of complication but not the type of device, eg. in-stent restenosis:

A proposals has already been made to ICD-10 C&M Committee to create new codes specifically defined for in-stent restenosis.5

ICD-9-CM ICD-10-CM

996.1

Mechanical complication of other vascular device, implant or graft

T82.310A Breakdown (mechanical) of aortic (bifurcation) graft (replacement)

T82.320A Displacement of aortic (bifurcation) graft (replacement)

T82.330A Leakage of aortic (bifurcation) graft (replacement)

T82.390A Other mechanical complication of aortic (bifurcation) graft (replacement)

5. March19-20, 2014 meeting of ICD-10 Coordination and Maintenance Committee http://www.cdc.gov/nchs/icd/icd9cm_maintenance.htm

10204027DOC Rev 1A

18

Status

ICD-9-CM ICD-10-CM

V45.82 Percutaneous transluminal coronary angioplasty status

Z95.5 Presence of coronary angioplasty implant and graftZ98.61 Coronary angioplasty status

Z95.820 Peripheral vascular angioplasty status with implants and grafts

Z98.62 Peripheral vascular angioplasty status

ICD-10-CM codes indicate that the patient is status post angioplasty in coronary and peripheral vessels.

The ICD-10-CM codes also specifically identify if angioplasty included placement of a stent.

10204027DOC Rev 1A

ICD-10-PCSProcedure Codes

19 10204027DOC Rev 1A

20

ICD-10-PCS Format

Codes are alpha-numeric and are always 7 digits long.

Each position in an ICD-10-PCS procedure code represents a distinct element.

1 2 3 4 5 6 7

sectionbody system

root operation approach qualifierbody part device

There is no decimal point.

There are virtually no unspecified or default codes.

10204027DOC Rev 1A

21

Structure of ICD-10-PCS Codes In ICD-10-PCS, codes are not assigned per se. They are

constructed, character by character.

ICD-10-PCS contains no instructional notes.

Standardized terms and definitions are used throughout.

10204027DOC Rev 1A

22

Volume of Procedure Codes ICD-10-PCS has far more procedure codes than ICD-9-CM and provides much greater specificity.

Angioplasty of LE Arteries

ICD-9-CM 1 code ICD-10-PCS 19 codes

ICD-9-CM3,882 codesICD-10-PCS71,924 codes

Use of ICD-10-PCS requires in-depth clinical and technical coding knowledge: Relevant clinical anatomy Procedural components Exact nature of devices used Standard terms, particularly Root Operation Procedure coding guidelines and precedents

10204027DOC Rev 1A

23

Coronary and Peripheral Procedures

Coronary Angioplasty and Stenting Coronary Aspiration Thrombectomy

Peripheral Angioplasty and Stenting

Abdominal Aortic Stent Graft

Cardiac Catheterization

Peripheral Atherectomy

Carotid Artery Stenting

Drug-Coated Balloon Angioplasty

Thoracic Aortic Stent Graft

Coronary and Peripheral Angiography 10204027DOC Rev 1A

24

Coronary Angioplasty and Stenting

Root Operation

Coding Guidelines

Because stenting is considered to inherently require angioplasty, stent insertion is shown by the Device character.

7 – Dilation : Expanding an orifice or the lumen of a tubular body part

The body part for coronary artery is defined by the number of discrete “sites” treated, regardless of whether they are within the same coronary artery, and not by the number of coronary arteries or their names.6

Coronary angioplasty and coronary stenting use the same root operation.

see also General Equivalence Mappings - Documentation for Technical Users, 2015, p.26-27http://www.cms.gov/Medicare/Coding/ICD10/2015-ICD-10-PCS-and-GEMs.html

6. AHA ICD-10-CM and ICD-10-PCS Coding Handbook, FY 2015, p.421

Separate codes are assigned for each coronary artery site dilated when the device value differs.7

7. ICD-10-PCS Official Guidelines for Coding and Reporting (Procedures), FY 2015, B4.4see also AHA ICD-10-CM and ICD-10-PCS Coding Handbook, FY 2015, p.422

10204027DOC Rev 1A

25

Coronary Angioplasty and StentingDevices 4 – Intraluminal Device, Drug-Eluting : Resolute Integrity D – Intraluminal Device : Integrity, Driver (bare metal)

Example

0270346 Dilation of coronary artery, one site, bifurcation, with drug-eluting intraluminal device, percutaneous approach

Angioplasty of two LAD sites-1st site: two drug-eluting stents at bifurcation, 2nd site: no stent, plus angioplasty of one RCA site with bare metal stent

02703ZZ Dilation of coronary artery, one site, percutaneous approach 02703DZ Dilation of coronary artery, one site, with intraluminal device, perc

10204027DOC Rev 1A

26

Coronary Angioplasty and StentingNotes

ICD-10-PCS does not have a mechanism to identify the total number of stents placed.

There is no equivalent to ICD-9-CM procedure codes 00.45–00.48.

A proposal has already been made to ICD-10 C&M Committee to expand the device values to show the number placed for both drug-eluting and non-drug-eluting stents.8

8. March19, 2014 meeting of ICD-10 Coordination and Maintenance Committee http://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/Downloads/03-19-14-ICD10-Agenda.pdf

This proposal also provided an option to change the body part for coronary artery from “site” to “artery”.

10204027DOC Rev 1A

27

Example

02C03ZZ Extirpation of matter from coronary artery, one site, percutaneous approach

Removal of thrombus in the left anterior descending coronary artery via Export aspiration catheter

Coronary Aspiration Thrombectomy

Root Operation C – Extirpation : Taking or cutting out solid matter from a body part

Coronary artery thrombus is typically removed in conjunction with other percutaneous coronary interventions as treatment for an AMI.

Notes A C&M proposal has already been made to add a qualifier for bifurcation.

10204027DOC Rev 1A

28


Root Operation

Coding Guidelines

7 – Dilation : Expanding an orifice or the lumen of a tubular body part

As with coronary, peripheral angioplasty and stenting use the same root operation and stent insertion is shown by the Device character.

Separate codes are assigned for each peripheral vessel dilated when the device value differs.

Devices D – Intraluminal Device : EverFlex, Complete, Assurant (bare metal)

10204027DOC Rev 1A

29

Example

047K3DZ Dilation of right femoral artery with intraluminal device, percutaneous approach

Insertion of two bare metal stents in right superficial femoral artery


Notes A C&M proposal has already been made to expand device values for the

number of peripheral stents placed, and to add a qualifier for bifurcation.

10204027DOC Rev 1A

30

Drug-Coated Balloon AngioplastyDCB is a newly-approved form of angioplasty. It is intended to reduce restenosis, combining the benefits of angioplasty and drug elution while avoiding the potential complications of a permanent stent.9

9. September 23, 2014 meeting of ICD-10 Coordination and Maintenance Committee http://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/Downloads/2014-09-23-ICD10-Agenda.pdf

New codes go into effect October 1, 2015.10

A new qualifier value was added to code table 047 for DCB for the femoral artery and popliteal artery body parts .

10. Federal Register, HIPPS proposed rule, April 30, 2015, p.24447-24452

Medtronic’s DCB is the IN.PACT Admiral.

10204027DOC Rev 1A

31

Peripheral Atherectomy Root Operation C – Extirpation : Taking or cutting out solid matter from

a body part

Coding Guidelines

If atherectomy is performed together with angioplasty or stenting, separate codes are assigned for both of the procedures.11

Minor intimal tears in the vessel wall that occur during atherectomy are considered an unavoidable part of the procedure and are not coded as complications.11

11. AHA ICD-10-CM and ICD-10-PCS Coding Handbook, FY 2015, p.422-423

10204027DOC Rev 1A

32

Example

04CN3ZZ Extirpation of matter from left popliteal artery, percutaneous approach

Removal of atherosclerotic plaque in the left popliteal artery via SilverHawk atherectomy catheter

Peripheral Atherectomy


10204027DOC Rev 1A

33

Carotid Artery StentingRoot Operation 7 – Dilation

Device D – Intraluminal Device : Protégé RX (bare metal)

Example Stenting of the right common carotid artery using Protégé RX

with Spider FX embolic protection device 037H3DZ Dilation of right common carotid artery with intraluminal device, percutaneous approach


10204027DOC Rev 1A

34


Root Operation V – Restriction : Partially closing an orifice or

the lumen of a tubular body part12

Abdominal aortic stent grafts are placed for endovascular aneurysm repair (EVAR). The AAA stent graft relines the aorta and provides a secure channel for blood flow, excluding the aneurysm sac.

Device D – Intraluminal Device : Endurant AAA Stent Graft

12. AHA ICD-10-CM and ICD-10-PCS Coding Handbook, FY 2015, p.435

Coding Guidelines One source implies that a separate code is not

assigned for extension of the stent graft into the common iliac artery strictly as a “landing zone” without pathology.13

13. AHIMA ICD-10-PCS: An Applied Approach 2015 (with answers), Chapter 11, Case Study 2, p.257-258

10204027DOC Rev 1A

35

Example

04V03DZ Restriction of abdominal aorta with intraluminal device, perc approach

EVAR of infrarenal abdominal aortic aneurysm with Endurant stent graft, anchored by ipsilateral and contralateral limbs in the common iliac arteries (patent iliac arteries)


10204027DOC Rev 1A

36


The thoracic aorta runs from the aortic valve to the diaphragm.

The precerebral arteries arise from the thoracic aortic arch. Blood flow to these critical vessels must be preserved.

Medtronic thoracic aortic stent grafts are used in the descending thoracic aorta.

Thoracic Aorta Anatomy

10204027DOC Rev 1A

37


Root Operation V – Restriction

Thoracic aortic stent grafts are placed for endovascular aneurysm repair.

Device D – Intraluminal Device : Valiant Thoracic Stent Graft,

Talent Thoracic Stent GraftExample

02VW3DZ Restriction of thoracic aorta with intraluminal device, perc approach EVAR of descending thoracic aortic aneurysm with Talent stent graft

Notes A C&M proposal has already been made to expand body part

values to differentiate descending thoracic aorta from ascending/arch.14

14. September 19, 2012 meeting of ICD-10 Coordination and Maintenance Committee http://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/Downloads/ICD9-Agenda-091912.pdf

10204027DOC Rev 1A

38

Thoracic Aortic Stent GraftAlthough less common than aneurysm, thoracic aortic stent grafts are also placed for blunt traumatic aortic injury, such as aortic transection.

Coding Guidelines It is not yet clear whether placement of a thoracic

aortic stent graft for indications such as aortic transection are also coded to the root operation V–Restriction or if they are coded to another root operation such as U–Supplement.

10204027DOC Rev 1A

39

Example

4A023N8 Measurement of cardiac sampling and pressure, bilateral

Right and left cardiac catheterization

Cardiac CatheterizationCardiac catheterization is coded in the Measurement and Monitoring section. It consists of threading a catheter into one of the chambers of the heart and performing hemodynamic recordings.

Coding Guidelines Angiography, which is almost always performed

with a cardiac catheterization, is coded separately.

10204027DOC Rev 1A

40

Example: Coronary

B2111ZZ Fluoroscopy of multiple coronary arteries using low osmolar contrast

Angiography of left main, LAD, and left circumflex coronary arteries and left ventriculography using Omnipaque

Coronary and Peripheral AngiographyAngiography is coded in the Imaging section. This involves injecting dye (contrast) and obtaining fluoroscopic images.

B2151ZZ Fluoroscopy of left heart using low osmolar contrast

10204027DOC Rev 1A

41

Example: Peripheral

B41D1ZZ Fluoroscopy of aorta and bilateral lower extremity arteries using low osmolar contrast

Angiography of abdominal aorta with bilateral runoff using Omnipaque

Coronary and Peripheral Angiography

10204027DOC Rev 1A

DRG Impact

42 10204027DOC Rev 1A

43

ICD-10 DRG ConversionThe conversion of the DRG Grouper is about coding, not about grouping.

The same DRG will be assigned regardless of whether the case is coded in ICD-9 or ICD-10.

CMS has repeatedly stated its goal in the DRG conversion:

The conversion process has involved only replacing the ICD-9-CM codes with the equivalent ICD-10 codes.

DRG titles and underlying DRG logic has not changed, but some minor DRG variations are unavoidable. In a study of 10 million FY 2013 MedPAR records, CMS found a

DRG shift of 1.07%, with reimbursement change of -0.04%15

15. Estimating the Impact of the Transition to ICD-10 on Medicare Inpatient Hospital Paymentshttp://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/Downloads/2015-03-18-Impact-ICD10-Transition.pdf

If the same DRG is not assigned, recheck the codes

10204027DOC Rev 1A

44

Sample CCs

Code DescriptionE44.0-E46 other malnutrition

E87.0 hypernatremiaE87.1 hyponatremia I31.4 cardiac tamponade

I42.0, I42.5, I42.8-I42.9

cardiomyopathy (non-ischemic) (dilated, congestive, constrictive, restrictive)

I44.2 AV block, complete I45.2 bifascicular block I45.3 trifascicular block

I45.89 other conduction disorder I47.2 ventricular tachycardiaI50.1 left ventricular failure

I50.20 systolic heart failure, unspecifiedI50.22 systolic heart failure, chronic I50.30 diastolic heart failure, unspecifiedI50.32 diastolic heart failure, chronic

I50.40 combined diastolic/systolic heart failure, unspecified

I50.42 combined diastolic/systolic heart failure, chronic

Code Description

I82.409-I82.891 venous thrombosis and embolism

J44.1 acute exacerbation of COPD

J80 acute respiratory distress syndrome (adult, child)

J90, J94.2, J94.8 pleural effusion, hemothorax, hydrothorax (non-traumatic)

J95.811-J95.812 iatrogenic pneumothorax, air leakJ96.10-J96.12 respiratory failure, chronicJ98.11-J98.19 atelectasis, pulmonary collapse

K56.0,K56.60-K56.7 bowel obstruction, ileus

N17.8-N17.9 acute renal failure, other and unspecified

N18.4 CKD, stage IV N18.5 CKD, stage V N39.0 urinary tract infection

R65.10 SIRSR78.81 bacteremia Z68.1 BMI less than 19, adult

Z68.41-Z68.45 BMI 40 and over, adult

10204027DOC Rev 1A

45

Sample MCCs

Code DescriptionA40.0-A40.9, A41.01-A41.9 septicemia, sepsis

E41-E43 severe malnutritionI21.01-I21.4, I22.0-I22.9 acute myocardial infarction

I26.01-I26.99 pulmonary embolismI50.21 systolic heart failure, acuteI50.23 systolic heart failure, acute on chronicI50.31 diastolic heart failure, acuteI50.33 diastolic heart failure, acute on chronicI50.41 combined diastolic/systolic heart failure, acuteI50.43 combined diastolic/systolic heart failure, acute on chronic

J12.0-J18.9 pneumoniaJ69.0 aspiration pneumoniaJ81.0 acute pulmonary edema

J96.00-J96.02 respiratory failure, acuteJ96.20-J96.22 respiratory failure, acute on chronic N17.0-N17.2 acute renal failure, specified lesion

N18.6 ESRDR65.20-R65.21 severe sepsis

10204027DOC Rev 1A

Appendix: Key Resources

46 10204027DOC Rev 1A

47

Key Websites NCHS and CMS have a wealth of ICD-10 resources and educational materials available on-line.NCHS http://www.cdc.gov/nchs/icd/icd10cm.htm#icd2105

• ICD-10-CM Tabular and Index • Diagnosis code GEMS• Official ICD-10-CM guidelines (diagnoses)

• ICD-10-PCS Code Tables and Index• Official ICD-10-CM guidelines (procedures)

CMS http://www.cms.gov/Medicare/Coding/ICD10/2015-ICD-10-CM-and-GEMs.html

• Procedure code GEMs

Procedures: http://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/ ICD-9-CM-C-and-M-Meeting-Materials.html

ICD-10 Coordination and Maintenance Committee

• Code proposals, presentation slides, videos, summaries

Diagnoses: http://www.cdc.gov/nchs/icd/icd9cm_maintenance.htm

10204027DOC Rev 1A

48

Medtronic Contacts Medtronic is available to assist with your ICD-10 questions and issues.

Hotline: 1-877-347-9662

Email us:[email protected]

We’re here to help make

this transition smoother for

you

Visit our reimbursement website at:http://www.medtronic.com/for-healthcare-professionals/ products-therapies/cardiovascular/therapies/coding-coverage-reimbursement-resources/index.htm

10204027DOC Rev 1A

Questions

10204027DOC Rev 1A

Medtronic Coronary and Peripheral Vascular ICD-10 … 2015 Medtronic Coronary and Peripheral...

Documents

Transcript of Medtronic Coronary and Peripheral Vascular ICD-10 … 2015 Medtronic Coronary and Peripheral...