Coding Ostomies in ICD-9 & ICD-10

Sometimes the difficulty in medical coding can be traced back to the lack of understanding of what is taking place during the encounter. For instance, knowing the difference between the types ostomies can assist the coder in assigning both the correct diagnosis codes and the procedural codes. This slideshare is an effort to illustrate the coding for some of the more common ostomies. There are certainly others to consider.

1. Cynthia Brown, MBA, RHIT, CCS Owner CyntCoding Health Information Services Coding Yesterday’s Nomenclature Today® Ostomy

2. Understanding is Vital Sometimes the difficulty in medical coding can be traced back to the lack of understanding of what is taking place during the encounter. For instance, knowing the difference between the types ostomies can assist the coder in assigning both the correct diagnosis codes and the procedural codes . This slideshare is an effort to illustrate the coding for some of the more common ostomies. There are certainly others to consider.

3. What is an OSTOMY? A surgically created opening connecting an internal organ to the outside of the body, creating a stoma. The type of stoma begins with the prefix of the organ being operated on and usually involve the gastrointestinal tract (the mouth or oral cavity through the anus). Ostomies can be permanent or temporary.

4. Types of Ostomies A tracheostomy is a surgical creation of an opening into the trachea (windpipe) through the neck allowing passage of air.

5. Types of Ostomies A gastrostomy is a surgical procedure for inserting a gastric tube (G-tube) through the abdominal wall into the stomach usually used for feeding but can also be used for drainage. The most common is the percutaneous endoscopic gastrostomy (PEG tube).

6. Types of Ostomies A colostomy is a surgically created opening on the abdomen which allows stool or urine to exit the body.

7. Types of Ostomies An ileostomy is created to act as an artificial excretory by connecting the ileum to an opening in the abdominal wall. This procedure requires the patient to wear a disposable bag to collect liquid fecal matter.

8. Types of Ostomies A jejunostomy is surgical creation of an opening through the abdominal wall into the jejunum for the purpose of placing a jejunostomy feeding tube (J tube) used for enteral feeding.

9. ICD-9 and ICD-10 Codes ICD-9 CM/PCS Tracheostomy V44.0 Status V55.0 Attention to 519.00-09 Complications 31.1 Temporary 31.21 Mediastinal 31.29 Other Permanent (Code also 33.21-33.24; 33.27 if performed) 31.74 Revision ICD-10 CM/PCS Tracheostomy Z93.0 Status Z43.0 Attention To J95.00-09 Complications 0B110F4; 0B113F4 0B110F4; 0B113F4 0B113F4 0B114F4 0BW10FZ; 0BW13FZ; 0BW14FZ; 0BW17FZ; 0BW18FZ; 0BW1XFZ

10. ICD-9 and ICD-10 Codes ICD-9 CM/PCS Gastrostomy V44.1 Status V55.1 Attention to 536.40-49 Complications 43.11 PEG 43.19 Other 44.68 Lap Revision 44.69 Revision Gastrostomy ICD-10 CM/PCS Gastrostomy Z93.1 Status Z43.1 Attention to K94.20-29 Complications 0DH63UZ; 0DH64UZ 0DH60UZ; 0DH67UZ; 0DH68UZ 0DW64UZ; 0DW68UZ 0DW60UZ; 0DW63UZ; 0DW67UZ; 0DW6XUZ

11. ICD-9 CM/PCS Colostomy V44.3 Status V55.3 Attention to 569.60-69 Complications 46.03 Loop Colostomy 46.10-14 Colostomies 46.43 Revision ICD-10 CM/PCS Colostomy Z93.3 Z43.3 K94.00-09 Complications 0DSH(K,L,M, N, P, or Q)0ZZ; 0DSH(K,L,M,N,P, or Q)4ZZ; 0DSH(K,L,M,N,P, or Q)7ZZ; 0DSH(K,L,M,N,P, or Q)8ZZ; 0DSH(K,L,M,N,P, or Q)XZZ 0D1H(K,L,M, or N)0Z4; 0D1H (K, L, M, or N)4Z4; 0D1H(K,L,M, or N)8Z4 0WQFXZ2

12. ICD-9 and ICD-10 Codes ICD-9 CM/PCS Ileostomy V44.2 Status V55.2 Attention to 569.60-69 Complications 46.01 Loop Ileostomy 46.20-24 Ileostomies 46.41 Revision ICD-10 CM/PCS Ileostomy Z93.2 Status Z43.2 Attention to K94.10-19 Complications 0DSB0ZZ; 0DSB4ZZ 0DSB7ZZ; 0DSB8ZZ 0DSBXZZ 0D1B0Z4; 0D1B4Z4; 0D1B8Z4 0WQFXZ2

13. ICD-9 CM/PCS Jejunostomy V44.4 Status V55.4 Attention to 569.60-69 Complications 46.31-39 Jejunostomies 46.41 Revision ICD-10 CM/PCS Jejunostomy V93.4 Status Z43.4 Attention to K94.10-19 Complications 0D1A0Z4 ; 0D1A4Z4 ; 0D1A8Z4 0WQFXZ2

14. Coding Yesterday’s Nomenclature Today® Accurate and complete coding is a must in today’s economically challenged healthcare environment. The uncertainties of the future for healthcare providers have raised the awareness to achieve optimal reimbursement while ensuring medical care is both cost-effective and medically necessary. CCHIS is dedicated to helping providers achieve optimal reimbursement through accurate and complete coding . ®

15. Cynthia Brown, MBA, RHIT, CCS AHIMA Approved ICD-10 CM/PCS Trainer CyntCoding Health Information Services Phone: [phone]/E-Fax: [phone] P.O. Box 3019 Decatur, GA 30031 [email protected] www.cyntcodinghealthinformationservices.com http://cyntcodinghealthinformationservices.blogspot.com Coding Yesterday ’ s Nomenclature Today ® CCHIS PRODUCTS & SERVICES CODING YESTERDAY’S NOMENCLATURE TODAY TERMS AND CONDITIONS OF USE   All content provided on this “CODING YESTERDAY’S NOMENCLATURE TODAY” blog is for informational purposes only. The owner of this blog makes no representations as to the accuracy or completeness of any information on this site or found by following any link on this site.   The owner of http://cyntcodinghealthinformationservices.blogspot.com will not be liable for any errors or omissions in information nor for the availability of this information. The owner will not be liable for any losses, injuries, or damages from the display or use of this information. The terms and conditions are subject to change at any time with or without notice.