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Coding malignant hyperthermia for optimal reimbursement

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The article discusses the diagnosis and coding guidelines for malignant hyperthermia – a severe reaction to a dose of anesthetics.

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Coding malignant hyperthermia for optimal reimbursement

  1. 1. Coding Malignant Hyperthermia for Optimal Reimbursement The article discusses the diagnosis and coding guidelines for malignant hyperthermia – a severe reaction to a dose of anesthetics. Outsource Strategies International 8596 E. 101st Street, Suite H Tulsa, OK 74133
  2. 2. www.outsourcestrategies.com 918-221-7769 Malignant Hyperthermia (MH) is a musculoskeletal syndrome that triggers a severe reaction to certain types of drugs/medications used as part of anesthesia for surgery and other invasive procedures. Typically, this reaction occurs in response to some anesthetic gases (used to block the sensation of pain) and muscle relaxants (used to temporarily paralyze a person) during a surgical procedure. These medications eliminate feelings of pain and provide relaxation to the muscles during surgeries and other medical procedures. In people with MH, exposure to these drugs can lead to deranged muscle function and rigidity, breakdown of muscle fibers (rhabdomyolysis), very high fever, rapid heart rate and breathing, failure of other organs (kidney, lung), faster metabolism, abnormal blood clotting and other life-threatening complications. Without proper treatment, the complications of malignant hyperthermia can be serious. To get appropriately reimbursed, anesthesiologists should make sure that the patient’s medical record contains sufficient documentation to support the need for treatment. Outsourcing anesthesiology medical billing and coding can ensure timely and accurate claim submission for optimal reimbursement. Reports suggest that malignant hyperthermia (MH) occurs in 1 out of every 5,000 to 50,000 people exposed to trigger medications. The Malignant Hyperthermia Association of the United States estimates that 1 in every 100,000 adults undergoing surgery develops the condition. It is estimated that MH occurs highest in children and young adults. Typically, malignant hyperthermia (MH) can occur during or after the administration of particular anesthetics or (succinylcholine type) muscle relaxants. In most cases, no signs and symptoms of the condition exist until you are exposed to anesthesia. MH is a genetic condition and is more common among people with muscle cells that contain unusual proteins. It can occur with an abnormal release of calcium in the body, when the muscle cells are triggered. Triggers include certain category of medications (known as volatile anesthetic agents), extreme heat, or strenuous physical activity. Diagnosis and Treatment Diagnosis and testing for the condition begins with a detailed physician evaluation wherein he/she will review your family medical history and determine the best course of action to
  3. 3. www.outsourcestrategies.com 918-221-7769 diagnose the condition. Several diagnostic tests like ECG, urine tests and blood tests will be conducted to determine the best course of action. In addition, genetic testing and muscle biopsies will also be conducted if you have a family member who has MH. Understanding the genetic factors will help people better manage further surgical procedures. One of the best ways to treat this condition is to avoid exposure to the medications that cause MH. Other treatment modalities include - administering dantrolene (Dantrium), applying ice packs, cooling blankets and using cold isotonic saline through an intravenous drip to reduce your body temperature. The diagnosis tests and other procedures performed by physicians must be carefully documented using the correct medical codes. Medical billing and coding services provided by reputable medical billing companies can help physicians use the correct codes for their medical billing purposes. ICD-10 codes used for Malignant Hyperthermia include – T88.3 - Malignant hyperthermia due to anesthesia  T88.3XXA - Malignant hyperthermia due to anesthesia, initial encounter  T88.3XXD - Malignant hyperthermia due to anesthesia, subsequent encounter  T88.3XXS - Malignant hyperthermia due to anesthesia, sequela T88.4 - Failed or difficult intubation  T88.4XXA - Failed or difficult intubation, initial encounter  T88.4XXD - Failed or difficult intubation, subsequent encounter  T88.4XXS - Failed or difficult intubation, sequela T88.5 - Other complications of anesthesia T88.51 - Hypothermia following anesthesia  T88.51XA- Hypothermia following anesthesia, initial encounter  T88.51XD - Hypothermia following anesthesia, subsequent encounter
  4. 4. www.outsourcestrategies.com 918-221-7769 Malignant Hyperthermia (MH) is a serious condition. If you have a family history of MH, a history of heat stroke/hyperthermia after exercise or experience muscle abnormalities (associated with MH) it is important to notify the anesthesiologist or surgeon prior to the surgery as they can avoid using succinylcholine or high-risk anesthetics and prepare in advance to control any type of reactions. Managing medical coding for Malignant Hyperthermia (MH) can be a challenging process. Outsourcing medical coding tasks to an established medical billing company is the practical way to ensure accurate and timely medical billing and claims submission. You benefit from the services of AAPC-certified coding specialists who are well-versed in coding and billing guidelines relevant to this specialty.

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