Published in the September 2007 issue of Today’s Hospitalist
The deadline for using the new and revised ICD-9 codes is fast approaching. Effective Oct. 1, physicians will have 144 new ICD-9 codes to contend with, in addition to already existing ICD-9 codes.
The good news? Most of those additions bring more specificity to diagnosis codes.
The not-so-good news? You must use the new (and revised) codes for services dated Oct. 1 and beyond, with no grace period allowed for implementation.
Other code news as of Oct. 1: Sixteen codes were deleted and should no longer be used (see “Revised and deleted ICD-9 codes“), while the description for five codes was revised. Be sure your charge documents and billing software are in the process of being updated, and familiarize yourself with the code changes. Otherwise, you can expect delays “or even denials “in reimbursement for your services after Oct. 1.
Here’s a look at the latest code changes that pertain to hospitalists. A complete list of all new, revised and deleted codes is online.
Effective Oct. 1, the diagnosis code 789.5: Ascites is defunct. Instead, physicians should use a new code requiring a “9” as the fifth digit. The new code is: 789.59: Other ascites.
Cardiovascular and transient ischemic attack (TIA)
The CMS is introducing the following new V codes for personal and family history of cardiac arrest and TIA:
- V12.53: Personal history of sudden cardiac arrest
- V12.54: Personal history of transient ischemic attack (TIA)
and cerebral infarction without residual deficits
- V17.41: Family history of sudden cardiac death
- V17.49: Family history of other cardiovascular diseases
The CMS is deleting the diagnosis code 787.2: Dysphagia for fiscal year 2008. It is, however, creating six new dysphagia codes to identify the phase of swallowing that is causing the problem.
- 787.20: Dysphagia, unspecified
- 787.21: Dysphagia, oral phase
- 787.22: Dysphagia, oropharyngeal phase
- 787.23: Dysphagia, pharyngeal phase
- 787.24: Dysphagia, pharyngoesophageal phase
- 787.29: Other dysphagia
There are eight new codes to describe infection, encephalitis and roseola infantum linked to human herpesvirus 6 or human herpesvirus 7. Simply coding “roseola” will no longer suffice.
- 058.10: Roseola infantum, unspecified
- 058.11: Roseola infantum due to human herpesvirus 6
- 058.12: Roseola infantum due to human herpesvirus 7
- 058.21: Human herpesvirus 6 encephalitis
- 058.29: Other human herpesvirus encephalitis
- 058.81: Human herpesvirus 6 infection
- 058.82: Human herpesvirus 7 infections
- 058.89: Other human herpesvirus infection
The CMS has created 54 new lymphoma codes that are more specific about the type of lymphoma and which lymph nodes are involved. Use the new 200 series codes (200.30-202.78) for marginal zone, mantle cell, primary central nervous system, anaplastic large cell and peripheral T cell lymphoma. Do not use the unspecified codes 202.80-202.88 (other lymphomas; lymphoma [malignant] NOS diffuse).
Kristy Welker is an independent medical coding consultant based in San Diego. E-mail your documentation and coding questions to her at email@example.com. We’ll try to answer your questions in a future issue of Today’s Hospitalist.
The following ICD-9 codes take effect as of Oct. 1, 2007:
- 005.1: Botulism food poisoning
- 389.3: Periodic paralysis
- 389.14: Central hearing loss
- 389.18: Sensorineural hearing loss, bilateral
- 389.7: Deaf, nonspeaking, not elsewhere classifiable
As of Oct. 1, the following codes are invalid:
- 233.3: Carcinoma in situ, other and unspecified female genital organs
- 255.4: Corticoadrenal insufficiency
- 258.0: Polyglandular activity in multiple endocrine adenomatosis
- 284.8: Other specified aplastic anemias
- 359.2: Myotonic disorders
- 364.8: Other disorders of iris and ciliary body
- 389.2: Mixed conductive and sensorineural hearing loss
- 624.0: Dystrophy of vulva
- 787.2: Dysphagia
- 789.5: Ascites
- 999.3: Complications of medical care, not elsewhere classified, other infection
- V17.4: Family history of other cardiovascular diseases
- V18.1: Family history of other endocrine and metabolic diseases
- V26.4: Procreative management, general counseling and advice
- V26.8: Other specified procreative management
- V68.0: Issue of medical certificates
- V84.8: Genetic susceptibility to other disease