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When ICD-9 to ICD-10 transition takes place in 2013, you will not always have an easy one-to-one relationship between old codes and the new codes. See how your ICD-9 codes will change in the following instances when the ICD-10 transition finally takes place.
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Tip: A diagnosis that falls under an ICD-9 ‘other’ code may have its own ICD-10 code.
Under ICD-9, when the manual doesn’t offer a code specific to your diagnosis, you usually choose one of the catch-all “other specified” codes available, such as 425.4 (Other primary cardiomyopathies). When you start applying ICD-10 codes in October 2013, you may find that your catch-all code has been divided into more specific options. Here’s how the ICD-10 counterparts for 425.4 will look.
ICD-9 coding rules: Cardiomyopathy literally means disease of the heart muscle and can refer to many types of heart disease. ICD-9 offers one code for “other” primary cardiomyopathies: 425.4. It’s appropriate for cardiomyopathy NOS, congestive, constrictive, familial, hypertrophic, idiopathic, nonobstructive, obstructive (but see 425.1 for hypertrophic obstructive), and restrictive. Code 425.4 is also appropriate for cardiovascular collagenosis.
ICD-10 changes: ICD-10 divides your options for “other” cardiomyopathy among three codes:
Code I42.2 will be appropriate for other cardiomyopathy: hypertrophic, nonobstructive. Code I42.5 will be appropriate for other cardiomyopathy: restrictive, constrictive NOS. Code I42.8 is appropriate for any other cardiomyopathies not listed elsewhere, including newborn and obscure of Africa, as well as cardiovascular collagenosis.
Caution: Check the index and full I42.- range in the tabular list before choosing an “other” code. For example, several of the diagnoses that fall under 425.4 in ICD-9 do not fall under the “other” cardiomyopathy codes in ICD- 10. Specifically, obstructive cardiomyopathy is coded to I42.1 under ICD-10, congestive falls under I42.0, and familial and idiopathic fall under I42.9.
Remember: When ICD-10 goes into effect on Oct. 1, 2013, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.
Be ready...
Lolita Jones, RHIA, CSS, independent coding and billing consultant, discusses five ways ICD-10 will affect “front office” processes in an ambulatory surgery center. This article is the second installation in a four-part series. -memberlock Login to Read More
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