ACS develops ICD-9 to ICD-10 crosswalk to assist in billing

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
K62.1 Rectal polyp
569.1 Rectal prolapse K62.2 Anal prolapse
K62.3 Rectal 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
K94.12 Enterostomy infection
569.62 Mechanical complication of colostomy and enterostomy K94.03 Colostomy malfunction
K94.13 Enterostomy malfunction
569.69 Other complications K94.09 Other complications of colostomy
K94.19 Other complications of enterostomy
569.7 Complications of intestinal pouch
569.71 Pouchitis K91.850 Pouchitis
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
553.2 Ventral hernia
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

Resources

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:


*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.

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