ACC.book Page 1 W ednesday, N ovem ber 23, 2011 12:23 PM Anesthesia Cross Coder Essential links from CPT® codes to ICD-9-CM and HCPCS codes 2013 ACC.book Page 1 W ednesday, N ovem ber 23, 2011 12:23 PM Contents Introduction .......................................................... i Perineum...........................................................295 CPT Anesthesia to Procedure Crosswalk ................i Pelvis (Except Hip) ...........................................330 Format...................................................................i Upper Leg (Except Knee)..................................339 Icon Key ...............................................................ii Knee and Popliteal Area....................................357 CPT Codes............................................................ii Lower Leg (Below Knee, Includes Resequenced Codes .............................................iii Ankle and Foot).............................................377 Code Links ..........................................................iii Shoulder and Axilla ..........................................396 ICD-9-CM Diagnostic Codes................................iii Upper Arm and Elbow......................................409 ICD-9-CM to ICD-10 Transition..........................iv ICD-9-CM Procedure Codes .................................v Forearm, Wrist, and Hand................................422 ICD-9-CM Volume 3 to ICD-10-PCS Transition ...v Radiological Procedures....................................445 HCPCS Level II Codes ..........................................v Burn Excisions or Debridement........................465 Modifiers ..............................................................v Obstetric ...........................................................472 Summary .............................................................vi Other Procedures..............................................481 CPT Procedure to Anesthesia Code ..................... 1 Introduction/Injection of Anesthetic Agent Head ................................................................... 37 (Nerve Block), Diagnostic or Therapeutic.....482 Neck ................................................................. 122 Moderate (Conscious) Sedation........................489 Thorax (Chest Wall and Shoulder Girdle)....... 144 Appendixes Intrathoracic..................................................... 163 Modifiers.......................................................... 491 Spine and Spinal Cord ..................................... 201 Glossary ........................................................... 493 Upper Abdomen............................................... 221 Lower Abdomen............................................... 247 Crosswalks © 2011 Optum CPT © 2011 American Medical Association. All Rights Reserved. 1 ACC.book Page i W ednesday, N ovem ber 23, 2011 12:23 PM Introduction OptumInsight is pleased to present the 2012 Anesthesia Cross Coder. inappropriate. Assuming all rules of anesthesia coding are followed, Fully comprehensive, the Anesthesia Cross Coder links more than excepted diagnosis codes may prove appropriate to a specific code 300 CPT codes commonly used by anesthesiologists to scenario. corresponding surgical CPT and ICD-9-CM diagnosis codes, and as Anesthesia Cross Coder does not include coding rules or guidelines. appropriate, ICD-9-CM procedure and HCPCS Level II codes. Once again, the user is urged to consult the original coding OptumInsight believes that professional coders working in reference (e.g., CPT, ICD-9-CM, HCPCS Level II, etc.) or one of physician offices, clinical outpatient areas, hospitals, as well as several reputable medical coding instruction manuals. payer settings will find this reference a useful tool. Anesthesia Cross Coder is based on the Anesthesia section of CPT Anesthesia to Procedure Code Physicians’ Current Procedural Terminology (CPT®), but includes Crosswalk CPT codes commonly used by practicing anesthesiologists from The surgical CPT codes are listed with the corresponding anesthesia other sections of the CPT system as well. Up-to-date CPT codes link CPT codes. The relationships were developed by comparing each to the following related medical coding systems: individual surgical CPT code, current practice patterns, and • International Classification of Diseases, 9th Revision, Clinical techniques to determine the appropriate relationship of the surgical Modification (ICD-9-CM) code to the anesthesia CPT code assignment. Using this • Healthcare Common Procedure Coding System (HCPCS) methodology, the surgical codes and anesthesia codes are assigned Level II the most appropriate coding relationships. OptumInsight does not rely on the combinations suggested by other organizations or All coding relationships in Anesthesia Cross Coder start with the groups with the exception of CMS. Reimbursement data was not Anesthesia section of the CPT book presenting a general clinical used to suggest one code combination over another. picture of each anesthesia code. Pertinent surgical related coding relationships were carfully reviewed and screened for appropriate Format information. An understanding of the Anesthesia Cross Coder format allows users In some instances, the data is abridged simply due to the enormity to easily navigate its content. Information within the main section of the listings. For example, diagnosis codes for infections call for ties to the CPT book and the codes are presented in the same additional codes to identify specific organisms. The possible numeric order as the anesthesia and other appropriate CPT associations are too numerous and do not appear in Anesthesia Cross sections. Coder. In a similar vein, Anesthesia Cross Coder features codes that Sections require accompanying etiologies or manifestations (e.g., “Code first Anesthesia Cross Coder provides linked information to the CPT code underlying disease”). However, associated infectious and parasitic range 00100 to 01999, as well as several other code ranges typically diseases are, once again, simply too numerous to list and do not used by anesthesiologists. The codes are divided into the same appear in Anesthesia Cross Coder. For further discussion on sections as found in the CPT book. secondary diagnosis codes, see the ICD-9-CM section later in this introduction. Codes and Code Ranges The data within each CPT code set of Anesthesia Cross Coder is Some CPT codes are omitted from the listing because consistent presented as follows: and reliable cross-links are almost impossible to establish. Unlisted procedure codes are an obvious example. As a coding reference, • Anesthesia CPT code Anesthesia Cross Coder presents most likely scenarios as derived • Corresponding surgical CPT codes and descriptions from clinical information and official sources. Anesthesia Cross Coder • ICD-9-CM diagnostic codes and descriptions is not a substitute for ICD-9-CM or any other medical coding reference and users are urged to regularly consult all available • ICD-9-CM procedural codes and descriptions, where sources. The absence of any specific code does not necessarily applicable indicate that its association to the base procedure code is • HCPCS Level II codes and descriptions, where applicable Crosswalks © 2011 Optum CPT © 2011 American Medical Association. All Rights Reserved. i CPT Procedure to Anesthesia Code 0048T 00600 00541 10080 01630 11305 00560 0218T 0262T 00300 01740 00300 01830 0050T 00620 00560 10081 00400 00920 00560 0219T 00561 00300 11042 00562 00300 00940 00600 0051T 10120 00400 00580 00630 0263T 00300 11306 01953 00300 0220T 01112 00400 0052T 11043 00400 00620 0265T 00580 10121 00300 00920 01112 0053T 0221T 00300 00400 00940 00400 00580 00630 0266T 01250 11307 00350 01320 0071T 0234T 10140 00300 00300 01470 00940 00770 0267T 00400 00350 00400 01610 00920 0072T 0235T 00920 01710 00940 00940 00770 0268T 00940 01810 01924 00350 01953 11308 0073T 10160 00300 01922 0236T 0269T 00300 11044 00400 00770 00350 00400 00160 00920 0075T 00190 00350 0237T 0270T 00940 10180 00450 01925 01650 00350 00300 11310 01770 00470 0078T 0271T 00400 01120 00300 00770 0238T 00350 11000 01170 11311 01926 00770 0274T 00300 01210 00300 01270 0080T 01936 00400 01230 01360 11312 01925 0239T 0275T 11004 01392 00300 01922 00400 0099T 01936 01400 11313 00140 0245T 0276T 11005 01480 00300 00470 0100T 00520 00400 01630 00700 01740 11400 00145 0246T 0277T 00300 00470 00800 01742 0102T 00520 00400 11006 01830 01730 0247T 11401 0281T 00400 11055 00470 00300 0123T 01920 00300 11010 00400 00147 0248T 0282T 00400 00470 00300 00300 11402 0124T 00400 11056 00300 00140 0249T 0283T 00300 00902 11011 00400 0169T 00300 00400 00300 11403 00214 0251T 0284T 00400 11057 00520 00300 00300 00700 00300 0171T 00400 00630 0253T 00400 00730 00400 00670 00140 0288T 01170 11100 11404 01250 00300 0254T 00902 00300 0184T 01320 00400 00902 01924 00400 0293T 01470 11406 0255T 01920 01610 11200 0195T 00300 01924 01710 00300 00630 0294T 00400 00670 01810 00400 0256T 01920 11420 00560 11300 0200T 0299T 11012 00300 00561 00190 00300 01936 00300 00400 00562 00300 00400 00400 00920 0201T 00400 0257T 01200 11301 00940 01936 00450 00560 01462 00300 11421 0202T 00561 01610 00470 00400 00300 00630 00562 01120 10060 01170 11302 00400 0205T 0258T 00300 01230 00300 00920 00140 00540 00400 01360 00400 00940 0207T 00541 10061 01392 11303 11422 00140 0259T 00300 01400 00300 00300 0217T 00540 00400 01480 00400 00400 CPT only © 2011 American Medical Association. 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