Basic ICD-9-CM volume 3

1
Basic ICD-9-CM
2
???????????????????????(ICD-9-CM 2007)

• ICD-9-CM ???????????????????????????
  ?????????????????????????????????
  ???????????????? ICD-9 ???????????????????
  ???????????????????????????????????
  ????????????????????????????????????????
  ??????????????????????????? ????????? ??.1978
  (??.2521)

3
???.?. 2537
Diagnostic code

• ICD-10

• ICD-9-CM vol.3

Procedure code
4
1986
5
ICD-9-CM 2007

• ?????????????????? 2 ???? ??????????? 1-2 ????
• ?????? Therapeutic ??? diagnostic procedures
• ???????????????????????????? (Anatomy)
• ???? 01-86 Procedures ??? Organ system
• ???? 87-99 Miscellaneous (Non OR) procedures
• Radiology
• Laboratory exam
• Interview, evaluation, consultation
  examination
• Nuclear medicine
• Rehabilitation
• Procedures related to the psyche
• Nonoperative intubation irrigation
• ..
• ???? 00 PROCEDURES INTERVENTIONS, NEC

6
1st2nd code (organ)
3rd code
3rd code
3rd code
4th code
7
Surgical therapeutic proc.
Surgical diagnostic proc.
8
Non-surgical therapeutic procedures
9
Non-surgical therapeutic procedures
10
Non-surgical therapeutic procedures
Non-surgical therapeutic procedures
11
Non-surgical diagnostic procedures
12
?????????? ICD-9-CM 2007

• ?????????? 16 ??
• 1.Operations on the nervous system (01-05)
• 2.Operations on the endocrine system (06-07)
• 3.Operations on the eye (08-16)
• 4.Operations on the ear (18-20)
• 5.Operations on the nose,mouth and pharynx
  (21-29)
• 6.Operations on the respiratory system (30-34)
• 7.Operations on the cardiovascular system (35-39)
• 8.Operations on the hemic and lymphatic system
  (40-41)

13
?????????? ICD-9-CM 2007

• 9.Operations on the digestive system (42-54)
• 10.Operations on the urinary system (55-59)
• 11.Operations on the male genital organs (60-64)
• 12.Operations on the female genital oorgans
  (65-71)
• 13.Obstetrical procedures (72-75)
• 14.Operations on the musculoskeletal system
  (76-84)
• 15.Operations on the integumentary system (85-86)
• 16.Miscellaneous diagnostic, therapeutic
  procedures (87-99)

14

• Instructional Notations
• Includes
• Excludes

• Abbreviations
• NEC (Not elsewhere classifiable) Lack of the
  necessary information to code more specific term
• NOS (Not otherwise specified) The equivalent
  of Unspecified

• Code also
• ??????????????????????????????
• ??????????????????????????????????????????

42.6 Antesternal anastomosis of esophagus
Code also any synchronous Esophagectomy
(42.40-42.42) Gastrostomy (43.1)
39.21 Caval-pulmonary artery anastomosis
Code also cardiopulmonary bypass (39.61)
13.71 Insertion of IOL at time of cataract
extraction, one stage Code also synchronous
extraction of cataract (13.11-13.69)
15
Procedure

• OR procedure
• Non OR procedure

• OR Proc. ????????????????????????????????????????
  ????????????????? (???????????????????????????)
• Non OR Proc. ????????????????????????????????????
  ???????????????????????? (?????????????????
  ??????????????????????)

16
Non-OR procedure
Non-OR procedure affect DRG
17
??????????????????????

• Medical statistic
• Medical care review
• Reimbursement

18
????????????????????????????????????

• Surgical procedures (01-86) ??????????
• Non-surgical procedures (87-99)
  ??????????????????????????????????????????????
  ????
• 96.71 Continuous mechanical ventilation for less
  than 96 consecutive hours
• 99.25 Injection or infusion of cancer
  chemotherapeutic substance
• 87.03 Computerized axial tomography of head

19
Ex. Pregnancy with low forceps delivery PDx.
Proc.
O81.0 Low forceps delivery
72.1 Low forceps operation with episiotomy
Ex. Term pregnancy delivered of dead fetus 2800
g PDx. Proc.
O36.4 Maternal care for intrauterine death
O80.9 Single spontaneous delivery,unspecified
73.59 Assisted spontaneous delivery
Ex. Acute renal failure on hemodialysis PDx.
Proc.
N17.0 Acute renal failure with tubular necrosis
39.95 hemodialysis
20
?????????????????????? 2

• ????????????????? 3 ???????
• 1.??????????????
• 2.???????????????????????
• 3.??????????????

21

• ??????????????????????????1
• Craniotomy ???????????????
• Craniectomy ???????????????
• Thoracotomy ??????????????
• Explore Laparotomy ????????????
• Laminectomy ?????????????????????
• Arthrotomy ????????????

???????????????????????? ?????????????????????????
????????????
22
Craniotomy with clot removal of subdural hematoma

• 01.24 Other craniotomy
• 01.31 Incision of cerebral meninges
• Drainage of subdural hematoma

23
Operation Explore with splenectomy
415 Splenectomy

• ?????????????????????
• 5411 Exploratory laparotomy

24
FB in esophagusOperation
Esophagoscope and FB Removal
98.02 FB removal from esophagus

• ???????????? remove FB 42.23 Other
  Esophagoscopy

25
Never code directly from the Index

• ?????????????????????????????????????????????

• ????????????????????????
• ?????????????????????????
• ???????????????????????

26
?????????????????????????????

• ?????????????????????????????????
• 1.???????????????????
• 2.?????????????????????
• 3.???????????
• 4.???????????????
• 5.??????????

27
Root of operation
Bypass ????????????????????? Drainage ??????????????? Reattachment ??????,?? ????
Control ??????,????????? Excision ??????????????????? Repair ???????
Creation ?????????????????? Extirpation ????????????? Reposition ???????????????????????
Destruction ???????????????,?????? Extraction ???????????? Resection ???????????????????
Detachmaent ?????? ?? ??????? Fragmentation ??????????????? Revision ??????????
Dilation ????????????? Fusion ?????????,?????? Transfer ?????????????????
Division ???????????????? Occlusion ???????????? Transplantation ??????????????
28

• Stop Bleeding from superior thyroid artery
• Control hemorrage thyroid

• Total Stitches Off
• Removal Suture

• Shunt or Anastomosis
• Bypass

??????????????????????? ???????????????????????? ?
??? Caldwells operation ????????? Caldwell
29

• Craniotomy to drain subdural hematoma
• 01.31 Incision of cerebral meninges
• Drainage of Subdural empyema

2. Repair sclera cornea 12.89 Repair
sclera 11.59 Repair cornea, NEC 11.51
Suture cornea 16.82 Repair multiple
structure of eye
30
OperationCesarean section
with appendectomy
741 Low cervical cesarean section 4719 Other
incidental appendectomy

• 47.0 Appendectomy
• 47.01 Laparoscopic appendectomy
• 47.09 Other appendectomy

Excludes incidental appendectomy,so
described(47.11,47.19)
31
Endometriosis Operation TAH BSO
PDx. N80.3 Endometriosis of pelvic
peritonium Proc.
68.4 Total abdominal hyterectomy Code
also removal of tube and ovary(65.3-65.6)
65.61 Other removal of both ovaries and
tubes at same operative episode
32
Total laryngectomy Radical neck dissection
Total thyroidectomy tracheostomy
CA larynx

• 30.3 Complete laryngectomy
• 40.41 Radical neck dissection, unilateral
• 06.4 Complete thyroidectomy
• 31.29 Other permanent tracheostomy

33
Total laryngectomy with radical neck dissection

• 30.4 Radical laryngectomy
• Complete ( total) laryngectomy with radical neck
  dissection (with thyroidectomy)(with synchronous
  tracheostomy)

34
???????????????? ?????????????????????????

• 47.0 Appendectomy
• Excludes incidental
  appendectomy,so described(47.11,47.19)
  

47.01 Laparoscopic appendectomy 47.09 Other
appendectomy
35
invalid code
valid code
valid code
36
Site code
Site code
valid code
37
Site code
Site code
38
Operation ORIF with plate
Fracture shaft of femur

• 79.3 Open reduction of fracture
  with internal fixation

5
femur
39

• Operation related to Dx. (????????????
  ????????????????)

40
ID

• 27.0 Drainage of face floor of mouth facial
  abscess, fascial compartment of face
• 28.0 Incision and drainage of tonsil and
  peritonsillar structures
• 86.04 Other incision with drainage of skin
  subcut. tissue

41
Deep neck abscessOperation ID

• PDx. L02.1 Cutaneous abscess of neck
• Proc. 86.04 Other incision with drainage of
  skin subcut. tissue

42

• PDx. K12.2 Cellulitis abscess of mouth
• Proc. 27.0 Drainage of facefloor of mouth
  facial abscess, fascial compartment of face

43
Alternate XTOperation RecessionResection
of muscle
of extraocular muscle
PDx. H50.1 Exotropia (alternating) Proc.
83.45 Muscle resection
15.3 Operation of two or more extraocular
muscles involving temporary detachment,one or
both eyes

• Extraocular muscle resection 15.13

• Resection of one extraocular muscle 15.13
• Recession of one extraocular muscle 15.11

44
?????????? ?????????
45
Functional Endoscopic Sinus Surgery ( FESS )

• ?????? operation ??????????????? ????
• 21.31 Local excision or destruction
• of intranasal lesion
• 22.63 Ethmoidectomy
• 22.52 Sphenoidotomy
• ???????

46
Warrens Shunt

• ????????????????????????????????????? ??????? ???
  Splenal vein ??? Renal vein

• ??????????????? Bypass Bypass
• Vascular
• Splenorenal 39.1

39.1 Intra-abdominal venous shunt
Anastomosis splenic and renal veins
47
Anterior resection with colostomy
Blephaloplasty

• Hartmann procedure
• Corpectomy
• Eyelid rhytidectomy
• SIC, SMC, ICCE, ECCE, PE, IOL
• LT C/S with TR
• MI

Spinal fusion, anterior technique
Low transverse C/S
Myocardial infarction VS Mitral insufficiency
48

• ??????
• ??????????????????