Q: One of our physicians is getting conflicting information regarding the ICD-10 codes E66.01 and E66.9. We have been coding E66.9 for Body Mass Indexes (BMIs) between 30-34 and E66.01…
The new fifth-digit diagnosis codes for body mass index (BMI) can help you better document a patient’s condition, especially when the patient’s BMI might contribute to more complex risk factors for the anesthesiologist to handle. Having documentation of a high BMI doesn’t automatically lead to more pay, however. Watch two areas before assuming you can automatically append modifier 22 (Increased procedural services) because of BMI and potentially score a 20-30 percent higher pay for the procedure.
Not All Morbid Obesity Means Modifier 22
A patient is considered to be morbidly obese when his or her BMI is 40 or more. New BMI codes for 2011 include:
While morbid obesity can be an appropriate reason to report modifier 22, don’t assume you should always append the modifier just because the patient is morbidly obese.
Example 1: During surgical procedures that are performed because of morbid obesity (such as bariatric surgery), the patient must meet the morbidly obese criteria too support medical necessity for the procedure. In those type instances, simply having a patient who is morbidly obese doesn’t support using modifier 22. Remember, if you report a physical status modifier for a patient who is morbidly obese, it is not appropriate to also include modifier 22. Keep in mind that Medicare does not pay for physical status, qualifying circumstances, or extra work modifiers.
The anesthesia provider’s documentation should direct you to the correct BMI code as well as support when you can append modifier 22.
Example 2: The patient’s obesity might contribute to breathing problems that lead to lower oxygen and...
Check out V13.65 for corrected congenital heart malformations.
Each October you’re faced with new ICD-9 codes to add to your diagnosis arsenal. 2011 is no exception, with new ectasia, congenital malformation, and body mass index (BMI) codes you’ll need to learn. Take a look at the proposed changes that will affect your cardiology practice, so that you’re ready when fall rolls around.
End Your Ectasia Hunt at 447.7x
The proposed changes to ICD-9 2011 add four codes specific to aortic ectasia, which could be among the most significant changes for cardiology coders.
“Ectasia” means dilation or enlargement, and aortic ectasia often refers to an enlargement that is milder than an aneurysm. But ICD-9 2010 does not distinguish ectasia from aneurysm, linking 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 are based on anatomic site:
New Corrected Congenital Malformations Code
A number of new codes deal with congenital malformations of the heart and circulatory system. Code V13.65 (Personal history of [corrected] congenital malformations of heart and circulatory system) will be “very useful to our practice,” says Janel C. Peterson, CPC, with Alegent Health Clinic Heart and Vascular Specialists in Omaha, Neb.
Add BMI V Codes to Your E/M Arsenal
The ICD-9 proposal has “expanded the body mass index (BMI) codes to demonstrate higher BMIs with five new codes,” notes Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CENTC, CHCC, with CRN Healthcare Solutions in Tinton Falls, N.J.
You’ll need to stop using V85.4 (Body Mass Index 40 and over, adult) on Oct. 1 and start...
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....