Tag Archives | Maintenance Committee

ICD-9 2011: Avoid H1N1, Fecal Incontinence Denials With 5th Digit Savvy

488.1x Cheat sheet makes fast work of snagging correct code.

Don’t let rumors of few ICD-9 changes in prep for ICD-10 blindside you to top diagnosis changes for 2011. Without the scoop on expansion to the 488, 784, and 787 categories, denials for invalid codes will derail your claims delaying your payments.

In ICD-9 2011, “Codes continue to become more and more specific necessitating a provider to document clearly and thoroughly to allow for selection of the most specific and accurate code,” says Jennifer Swindle, RHIT, CCS-P, CEMC, CFPC, CCP-P, PCS, Director Coding & Compliance Division, PivotHealth, LLC.

Good news: Updating your ICD-9 coding by the Oct. 1, 2010, effective date doesn’t have to be a chore. Start using your new choices in no time flat following these guidelines.

Look at Manifestation When Assigning “Swine Flu” Dx

This fall, when a patient has H1N1 (“swine flu”) pay attention to two details. The medical record will have to identify the correct influenza and you will have to capture the appropriate manifestation to select the codes to the degree of specificity now required, Swindle points out.

With the change “category 488 (Influenza due to certain identified influenza viruses) would mirror the structure of category 487 (Influenza),” according to the Summary of March 2010 ICD-9-CM Coordination and Maintenance Committee Meeting. The current 488.x sub-category didn’t provide the level of detail that category 487 (Influenza) does.

Change: There will be “tremendous expansion of the H1N1 category,” Swindle explains. ICD-9 2011 deletes 488.0 and 488.1 and adds six new five-digit codes. New codes 488.0x (Influenza due to identified avian influenza virus) and 488.1x (Influenza due to identified novel H1N1 influenza virus) allow you “to uniquely capture pneumonia, other respiratory manifestations, and other manifestations occurring with these types of influenza,” states the summary.

Starting Oct….

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ICD-9 2011 Coding: Prepare for New Fluid Overload and Seizure Codes

Code 276.6 denials will plague you unless you’ve got the code’s expansion details.

Come October 1, you must be ready to report the new and changed 2011 ICD-9 codes. Now that CMS has finalized the update, you can get a jump start on the changes.

Add Detail to Fluid Overload

Starting in October, you’ll need to code with a higher degree of specificity when it comes to reporting fluid overload.

2010’s 276.6 (Fluid overload) category will expand to include the following:

  • 276.61 — Transfusion associated circulatory overload
  • 276.69 — Other fluid overload.

Transfusion-associated circulatory overload (TACO), a heart-related condition, “is a circulatory overload following transfusion of blood or blood components,” said Mikhail Menis, PharmD, MS, of the FDA CBER, who presented the proposal for this change at the September 2009 ICD-9-CM Coordination and Maintenance Committee meeting.

The patient may experience “acute respiratory distress, increased blood pressure, pulmonary edema secondary to congestive heart failure, positive fluid balance, etc., during or within 6 hours of transfusion.”

The new code 276.69 includes fluid retention. Another related addition at 782.3 (Edema) excludes fluid retention.

Define Post-Traumatic Seizures

Post-traumatic seizures are acute, symptomatic seizures following a head injury. In a Centers for Disease Control & Prevention release, the ICD-9-CM Coordination and Maintenance Committee explains that “a unique code for this type of seizure is important because these patients need to be followed for treatment as well as prognostic and epidemiologic considerations.”

Result: The creation of 780.33 (Post traumatic seizures) will further specify this type of seizure. Currently, you must look to the 780.3x (Convulsions) subcategory in order to report a patient’s symptoms.

As with other kinds of seizures, post-traumatic seizures may not occur until weeks or months after the injury, when the seizure may be considered a late effect of the…

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Radiology Coding: Watch for 4 Key ICD-9 Additions

From head to toe, the new diagnosis codes hold something for everyone.

Whether your patients present with cardiologic, orthopedic, or gynecologic complaints, the next round of ICD-9 codes could hold important changes for you. Here’s the rundown on the new codes most relevant to radiologists — including a new option for retained magnetic metal fragments.

Remember: ICD-9 2011 will go into effect Oct. 1, 2010. The official version will be released in the fall, so the codes below are not yet final.

1. Look Forward to More Specific Ectasia Codes

The proposed changes to ICD-9 2011 add four codes specific to aortic ectasia. These codes are among the most significant changes for radiology coders because you may see that term in your radiologist’s findings, says Helen L. Avery, CPC, CHC, CPC-I, manager of revenue cycle services for Los Angeles-based Sinaiko Healthcare Consulting Inc. “Ectasia” means dilation or enlargement, and aortic ectasia typically refers to enlargement that is milder than an aneurysm. But ICD-9 2010 does not distinguish ectasia from aneurysm, indexing aortic ectasia to 441.9 (Aortic aneurysm of unspecified site without mention of rupture) and 441.5 (Aortic aneurysm of unspecified site, ruptured).

The proposed 2011 codes are specific to aortic ectasia and differ based on anatomic site:

  • 447.70 — Aortic ectasia, unspecified site
  • 447.71 — Thoracic aortic ectasia
  • 447.72 — Abdominal aortic ectasia
  • 447.73 — Thoracoabdominal aortic ectasia.

2. Watch for ‘Claudication’ in Stenosis Report

Another one of the important changes is the proposed addition of 724.03 (Spinal stenosis, lumbar region, with neurogenic claudication), says Avery. The code refers to lumbar spinal stenosis, which is a narrowing of the spinal canal, according to the Sept. 16-17, 2009, ICD-9-CM Coordination and Maintenance Committee meeting proposal (available here). Neurogenic claudication “is a commonly used term for a…

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CMS Announces Over 100 New ICD9 Codes, Effective Oct. 1

Get ready for the dawn of new jaw pain, BMI codes, among others.

If you’ve got high hopes that you’ll benefit from many new ICD-9 codes starting this fall, CMS delivers, with over 130 new diagnosis codes debuting on Oct….

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