In 2003, the Health Insurance Portability and Accountability Act identified the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) as the standard code set for reporting medical and surgical diagnoses and inpatient procedures. ICD is a diagnostic tool used for epidemiology, health management, and clinical purposes.* Currently, ICD-9-CM includes both diagnosis and procedural codes.
ICD-9 will be transitioning to the ICD 10th Revision (ICD-10), October 1. ICD-10 is expected to be an expanded code set, including additional information for ambulatory and managed care and injuries. It is expected to combine diagnosis and symptom codes to better define certain conditions, increase specificity through greater code length, and provide the ability to specify laterality.†
ICD-10 will consist of two parts: ICD-10-Clinical Modification (CM) and ICD-10-Procedure Coding System (PCS). Surgeons and other health care professionals will use ICD-10-CM to report medical diagnoses. Hospitals will use ICD-10-PCS to report inpatient procedures. For more information on the differences between ICD-10-CM and ICD-10-PCS, view the American College of Surgeons (ACS) ICD factsheet.
To assist surgeons with the transition to ICD-10, the ACS has developed an ICD-9-CM to ICD-10-CM crosswalk of the most frequently reported general surgery diagnosis codes. It can be used as tool to help determine what a particular ICD-9 code will be translated to in ICD-10. It may also be used as a resource to aid in the billing process. Accurate coding is the responsibility of the provider.
ACS ICD-9 to ICD-10 crosswalk
The ACS analyzed the Current Procedural Terminology (CPT)‡ codes that general surgeons report most commonly and compared them with the most frequently reported ICD-9 codes. The crosswalk was developed using the three ICD-9 family codes with the highest frequency of being reported as a diagnosis within the top CPT codes. The specified ICD-9 codes within these families were then crosswalked with the appropriate ICD-10 code(s). The ICD-9 codes were mapped out to the appropriate ICD-10 codes using the website www.icd10data.com. The three ICD-9 family codes used in the ACS crosswalk include:
- 569 (other orders of the intestine)
- 553 (other hernia of abdominal cavity without mention of obstruction or gangrene)
- 459 (other disorders of the circulatory system)
The figure below illustrates the crosswalk.
ICD-10 Crosswalk for General Surgery
This crosswalk has been developed by the ACS and may be used as a basic guide for comparing a selection of frequently reported general surgery procedures between ICD-9 and ICD-10. Note that accurate coding is the responsibility of the provider. This crosswalk is intended only as a resource to assist in the billing process.
|ICD-9 (non-specified)||ICD-9||ICD-9 description||ICD-10||ICD-10 description|
|569–Other orders of the intestine||569.0||Anal and rectal polyp||K62.0||Anal polyp|
|569.1||Rectal prolapse||K62.2||Anal prolapse|
|569.2||Stenosis of rectum and anus||K62.4||Stenosis of anus and rectum|
|569.3||Hemorrhage of anus and rectum||K62.5||Hemorrhage of anus and rectum|
|569.4||Other specified disorders of the rectum and anus|
|569.41||Ulcer of anus and rectum||K62.6||Ulcer of anus and rectum|
|569.42||Anal or rectal pain||K62.89||Other specified diseases of anus and rectum|
|569.43||Anal sphincter tear (healed) (old)||K62.81||Anal sphincter tear (healed) (nontraumatic) (old)|
|569.44||Dysplasia of anus||K62.42||Dysplasia of anus|
|569.49||Other||K62.49||Other specified diseases of anus and rectum|
|569.5||Abscess of intestine||K63.0||Abscess of intestine|
|569.6||Colostomy and enterostomy complications|
|569.60||Colostomy and enterostomy complications, unspecified||K94.00||Colostomy complication, unspecified|
|K94.10||Enterostomy complication, unspecified|
|569.61||Infection of colostomy or enterostomy||K94.02||Colostomy infection|
|569.62||Mechanical complication of colostomy and enterostomy||K94.03||Colostomy malfunction|
|569.69||Other complications||K94.09||Other complications of colostomy|
|K94.19||Other complications of enterostomy|
|569.7||Complications of intestinal pouch|
|569.79||Other complications of intestinal pouch||K91.858||Other complications of intestinal pouch|
|553–Other hernia of abdominal cavity without mention of obstruction of gangrene||553.0||Femoral hernia|
|553.00||Unilateral or unspecified (not specific as recurrent)||K41.90||Unilateral femoral hernia, without obstruction or gangrene, not specified as recurrent|
|553.01||Unilateral or unspecified, recurrent||K41.91||Unilateral femoral hernia, without obstruction or gangrene, recurrent|
|553.02||Bilateral (not specified as recurrent)||K41.20||Bilateral femoral hernia, without obstruction or gangrene, not specified as recurrent|
|553.03||Bilateral, recurrent||K41.21||Bilateral femoral hernia, without obstruction or gangrene, recurrent|
|553.1||Umbilical hernia||K42.9||Umbilical hernia without obstruction or gangrene|
|553.20||Ventral (unspecified)||K43.9||Ventral hernia without obstruction or gangrene|
|553.21||Incisional||K43.2||Incisional hernia without obstruction or gangrene|
|553.29||Other||K43.9||Ventral hernia without obstruction or gangrene|
|K46.9||Unspecified abdominal hernia without obstruction or gangrene|
|553.3||Diaphragmatic hernia||K44.9||Diaphragmatic hernia without obstruction or gangrene|
|459–Other disorders of the circulatory system||459.1||Postphlebitic syndrome|
|459.10||Postphlebitic syndrome without complications||I87.009||Postthrombotic syndrome without complications of unspecified extremity|
|459.11||Postphlebitic syndrome with ulcer||I87.019||Postthrombotic syndrome with ulcer of unspecified lower extremity|
|459.12||Postphlebitic syndrome with inflammation||I87.029||Postthrombotic syndrome with inflammation of unspecified lower extremity|
|459.13||Postphlebitic syndrome with ulcer and inflammation||I87.039||Postthrombotic syndrome with ulcer and inflammation of unspecified lower extremity|
|459.19||Postphlebitic syndrome with other complications||I87.039||Postthrombotic syndrome with ulcer and inflammation of unspecified lower extremity|
The crosswalk can be found online. Surgeons should continue to monitor the ACS ICD-10 website leading up to the October 1 transition for more ICD-9 to ICD-10 coding examples and other important information.
For additional ICD-10 resources, visit the following sites:
- The American Academy of Professional Coders’ ICD-10 website
- The American Health Information Management Association ICD-10 website
- The American Hospital Association Central Office ICD-10 website
- The American Medical Association ICD-10 website
- The Centers for Medicare & Medicaid website and the CMS eHealth University
- The Healthcare Information Management Systems Society ICD-10 website
- Online tool for converting ICD-9 codes to ICD-10
*World Health Organization. International Classification of Diseases. Available at: www.who.int/classifications/icd/en/. Accessed December 8, 2014.
†American Medical Association. What you need to know about the upcoming transition to ICD-10. Available at: www.azmed.org/ckfinder/userfiles/files/icd-10-transition.pdf. Accessed December 8, 2014.
‡All specific references to CPT codes and descriptions are © 2013 American Medical Association. All rights reserved. CPT and CodeManager are registered trademarks of the American Medical Association.