ICD-10-CM Coding for Converting to an Open Approach

February 16, 2017

Question:
In ICD-9-CM, there was a specific diagnosis code for converting a laparoscopic procedure to open. I can’t find a similar code in ICD-10? What do you suggest? Having a diagnosis code for this can be helpful in justifying a 22 modifier for increased services, especially when I spend significant time in one approach before I have to convert to an open approach.

Answer:
You are correct, under ICD-9 the code, V64.4 Closed surgical procedure converted to open procedure with codes for laparoscopic (V64.41, thoracoscopic (V64.41) and arthroscopic (V64.43) 4 would be used to describe converting to an open procedure. No corollary code existed in ICD-10, 2016 version. But good news! The 2017 version of ICD-10 (effective October 1, 2016 – so right now!) has approximately 2000 new or revised codes and now includes codes for converting to an open procedure. The codes are:

  • Z53.31 Laparoscopic procedure converted to open
  • Z53.32 Thoracoscopic procedure converted to open
  • Z53.33 Arthroscopic procedure converted to open
  • Z53.39 Other specific procedure converted to open

Z53.39 would be appropriate for an endovascular procedure converted to an open surgical procedure.

*This response is based on the best information available as of 02/16/17.

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