Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Coding)
ICD-9-CM (continued) Volume 3 - Procedures: Tabular List and Alphabetic Index
11-8
Volume 3 is a numeric listing of procedure codes and descriptions
consisting of 17 chapters containing codes and descriptions for
surgical procedures and miscellaneous diagnostic and therapeutic
procedures. Codes from Volume 3 are intended only for use by
hospitals for inpatient services.
ICD-9-CM procedure codes are two-, three- or four-digit codes.
The base ICD-9-CM procedure code consists of two digits that
may be further defined or classified by a third or fourth digit
following a dot (this divides and identifies the base procedure). For
example: 50 is the procedure “Operations on liver.” “Closure of
laceration of liver” is coded as “50.61.” The addition of “.61”
specifically defines the liver operation. Only valid procedures
submitted to their full specificity, are accepted. If a third or fourth
digit applies to a specific procedures code, it must be submitted.
Linking/Pointing or Sequencing
In the professional claim record there are two diagnosis elements -
one is at the header level of the claim and the other is at the line
level and points to the values populated at the claim level. In the
837P electronic transaction record the Diagnosis Code Pointer is
found in the2400 loop - SV107-1, SV107-2, SV107-3, SV107-4.
The primary diagnosis for the service performed must be
appropriately linked to that service, especially if more than one
diagnosis relates to a line item. Up to eight diagnoses can be
submitted per professional claim and up to four of those can be
linked to a detail service line; however, adjudication is based on
the first linked diagnosis.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (07/12/12)