EmailACS 0020 Multiple/Bilateral Procedures and ECT
Publication Date: December 2005
ICD 10 AM Edition: Fourth edition
Retired Date: 30/6/2010
Query Number: 2197
My query relates to Standard 0020 - Multiple/Bilateral Procedures.
In section (b) of the 'exceptions' the Standard instructs coders to have one code assigned 'per OPERATIVE episode'.
As multiple administrations of ECT are each performed in different OPERATIVE episodes, but often within the one PATIENT episode, strict adherence to the Standard would suggest a coder should assign 93340-02 [1907] Electroconvulsive therapy [ECT] <=12 treatments at each OPERATIVE episode (followed by the anaesthetic code), rather than once for the PATIENT episode, followed by the anaesthetic code(s) for each OPERATIVE encounter.
Example:
Patient presents with severe depressive episode without psychotic symptoms and receives 4 treatments of ECT within the current admission, before separation for further same day ECT to complete the course.
Current method of recording:
F32.20 Severe depressive episode without psychotic symptoms
93340-02 [1907] Electroconvulsive therapy [ECT] <= 12 treatments
92514-99 [1910] General anaesthetic
92514-99 [1910] General anaesthetic
92514-99 [1910] General anaesthetic
92514-99 [1910] General anaesthetic
Following Standard 0020 – Multiple/Bilateral procedures
F32.20 Severe depressive episode without psychotic symptoms
93340-02 [1907] Electroconvulsive therapy [ECT] <=12 treatments
92514-99 [1910] General anaesthetic
93340-02 [1907] Electroconvulsive therapy [ECT] <=12 treatments
92514-99 [1910] General anaesthetic
93340-02 [1907] Electroconvulsive therapy [ECT] <=12 treatments
92514-99 [1910] General anaesthetic
93340-02 [1907] Electroconvulsive therapy [ECT] <=12 treatments
92514-99 [1910] General anaesthetic
Could you please clarify the correct method of reporting multiple episodes of ECT within the same patient episode?
In section (b) of the 'exceptions' the Standard instructs coders to have one code assigned 'per OPERATIVE episode'.
As multiple administrations of ECT are each performed in different OPERATIVE episodes, but often within the one PATIENT episode, strict adherence to the Standard would suggest a coder should assign 93340-02 [1907] Electroconvulsive therapy [ECT] <=12 treatments at each OPERATIVE episode (followed by the anaesthetic code), rather than once for the PATIENT episode, followed by the anaesthetic code(s) for each OPERATIVE encounter.
Example:
Patient presents with severe depressive episode without psychotic symptoms and receives 4 treatments of ECT within the current admission, before separation for further same day ECT to complete the course.
Current method of recording:
F32.20 Severe depressive episode without psychotic symptoms
93340-02 [1907] Electroconvulsive therapy [ECT] <= 12 treatments
92514-99 [1910] General anaesthetic
92514-99 [1910] General anaesthetic
92514-99 [1910] General anaesthetic
92514-99 [1910] General anaesthetic
Following Standard 0020 – Multiple/Bilateral procedures
F32.20 Severe depressive episode without psychotic symptoms
93340-02 [1907] Electroconvulsive therapy [ECT] <=12 treatments
92514-99 [1910] General anaesthetic
93340-02 [1907] Electroconvulsive therapy [ECT] <=12 treatments
92514-99 [1910] General anaesthetic
93340-02 [1907] Electroconvulsive therapy [ECT] <=12 treatments
92514-99 [1910] General anaesthetic
93340-02 [1907] Electroconvulsive therapy [ECT] <=12 treatments
92514-99 [1910] General anaesthetic
Could you please clarify the correct method of reporting multiple episodes of ECT within the same patient episode?
Response
The NCCH has previously published information regarding the number of episodes of ECT in Coding Matters Volume 7, Number 2. This information overrides ACS 0020 Multiple/Bilateral procedures.
The Victorian ICD Coding Committee has forwarded this query to the NCCH for consideration of removing ECT from the example box in part (b) of ACS 0020 and incorporating the advice in Coding Matters into the Classification by creating a separate category for ECT in ACS 0020 or creating a specialty standard for ECT.
The Victorian ICD Coding Committee has forwarded this query to the NCCH for consideration of removing ECT from the example box in part (b) of ACS 0020 and incorporating the advice in Coding Matters into the Classification by creating a separate category for ECT in ACS 0020 or creating a specialty standard for ECT.
