Coding malignant hyperthermia for optimal reimbursement
Coding Malignant Hyperthermia
for Optimal Reimbursement
The article discusses the diagnosis and coding guidelines for
malignant hyperthermia – a severe reaction to a dose of
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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
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
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
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.