Thursday 30 November 2017

Billing for Pancreas Transplants

If ICD-10 is applicable, the following procedure codes (ICD-10-PCS) are:

• 0FYG0Z0 Transplantation of Pancreas, Allogeneic, Open Approach 
• 0FYG0Z1 Transplantation of Pancreas, Syngeneic, Open Approach

Pancreas transplantation is reasonable and necessary for the following diagnosis codes. However, since this is not an all-inclusive list, the contractor is permitted to determine if any additional diagnosis codes will be covered for this procedure.

If ICD-9-CM is applicable, Diabetes Diagnosis Codes and Descriptions

ICD-9- CM Code Description 

250.00 Diabetes mellitus without mention of complication, type II (non-insulin dependent) (NIDDM) (adult onset) or unspecified type, not stated as uncontrolled. 

250.01 Diabetes mellitus without mention of complication, type I (insulin dependent) (IDDM) (juvenile), not stated as uncontrolled.

250.02 Diabetes mellitus without mention of complication, type II (non-insulin dependent) (NIDDM) (adult onset) or unspecified type, uncontrolled. 

250.03 Diabetes mellitus without mention of complication, type I (insulin dependent) (IDDM) (juvenile), uncontrolled.

 250.1X Diabetes with ketoacidosis 

250.2X Diabetes with hyperosmolarity 

250.3X Diabetes with coma 


250.4X Diabetes with renal manifestations

250.5X Diabetes with ophthalmic manifestations 

250.6X Diabetes with neurological manifestations

250.7X Diabetes with peripheral circulatory disorders 

250.8X Diabetes with other specified manifestations 

250.9X Diabetes with unspecified complication

NOTE: X=0-3

If ICD-10-CM is applicable, the diagnosis codes are: E10.10 - E10.9

Hypertensive Renal Diagnosis Codes and Descriptions if ICD-9-CM is applicable :

ICD-9-CM Code Description 
403.01 Malignant hypertensive renal disease, with renal failure 

403.11 Benign hypertensive renal disease, with renal failure 

403.91 Unspecified hypertensive renal disease, with renal failure 

404.02 Malignant hypertensive heart and renal disease, with renal failure 

404.03 Malignant hypertensive heart and renal disease, with congestive heart failure or renal failure 

404.12 Benign hypertensive heart and renal disease, with renal failure 

404.13 Benign hypertensive heart and renal disease, with congestive heart failure or renal failure 

404.92 Unspecified hypertensive heart and renal disease, with renal failure 

404.93 Unspecified hypertensive heart and renal disease, with congestive heart failure or renal failure

ICD-9-CM Code Description 
585.1 - 585.6, 585.9 Chronic Renal Failure Code

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