Here is what you should check in your physician’s documentation.
As the conversion takes place from ICD-9 to ICD-10 in 2013, you will not be treating the codes in a way you always did. Often, you will have more options that may need tweaking the way your physician documents a service and a coder reports it.
Have a look at this common ureteral stone diagnosis, and find out what you’ll report after October 1, 2013.
When your urologist treats a ureteral stone, you now apply ICD-9 code 592.1 (Calculus of ureter) to a specific procedure code (such as 52353, Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy [ureteral catheterization is included]).
ICD-10 difference is that
Instead of relying on one code, 592.1 will expand into four options:- N13.2 – Hydronephrosis with renal and ureteral calculus obstruction
- N13.6 – Pyonephrosis, conditions in N13.0-N13.5 with infection
- N20.1 – Calculus of ureter
- N20.2 – Calculus of kidney with calculus of ureter.
The key difference between the four new codes is the other conditions the patient may also have. When your urologist documents that the patient only has a ureteral stone, you’ll report N20.1. You will use N13.2 for a ureteral stone with hydronephrosis and N13.6 for a ureteral stone with hydronephrosis plus infection. If the patient has both a ureteral and a kidney stone, you’ll turn to N20.2.
Well the good news is that your urologist most likely already documents everything needed to choose the proper stone code in 2013.
If the doctor sees evidence of hydronephrosis or a renal stone, he’ll document that information. You need to review this information before assigning a specific ureteral stone diagnosis.
An updated super bill should list all four codes with an individual check box for each.
