Upper Limb – MedicalCodingNews.Org

CMS Proposes New Glaucoma, Skin Cancer, Dementia Codes

Many new codes abound in final update to proposed ICD-9-CM code set

If you’ve felt that your skin cancer diagnoses could use a bit more specificity, ICD-9 will deliver this October if the proposed list of new, deleted, and revised diagnosis codes becomes final. The list of ICD-9 changes was recently posted to the CMS Website, and includes the final full set of changes that the agency will make to ICD-9 codes. After the new codes take effect on Oct. 1, CMS will only add new ICD- 9 codes on an emergency basis as it prepares to switch over the diagnosis coding system to ICD-10.

Seek Out Skin Cancer Changes

You’ll find a significant expansion to the 173.x (Other malignant neoplasm of skin) categories, including changes to 173.0x (…Skin of lip), 173.1x (Eyelid, including canthus), 173.2x (Skin of ear and external auditory canal), 173.3x (Skin of other and unspecified parts of face), 173.4x (Scalp and skin of neck), 173.5x (Skin of trunk, except scrotum), 173.6x (Skin of upper limb, including shoulder), 173.7x (Skin of lower limb, including hip), 173.8x (Other specified sites of skin), and 173.9x (Skin, site unspecified).

Among these changes, for example, you’ll find the following new codes to delineate various types of skin cancers:

173.60 —Unspecified malignant neoplasm of skin of upper limb, including shoulder
173.61 — Basal cell carcinoma of skin of upper limb, including shoulder
173.62 — Squamous cell carcinoma of skin of upper limb, including shoulder
173.69 — Other specified malignant neoplasm of skin of upper limb, including shoulder.

The changes in the other skin cancer categories referenced above follow this pattern, with the fifth digit of “0” referring to an unspecified malignant neoplasm, “1” denoting a basal cell cancer, “2” referring to a squamous cell carcinoma,” and “9”...

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June 22, 2011

Coder's Cranium / General / Hot Coding Topics

CMS Proposes New Glaucoma, Skin Cancer, Dementia Codes

Many new codes abound in final update to proposed ICD-9-CM code set.

If you’ve felt that your skin cancer diagnoses could use a bit more specificity, ICD-9 will deliver this October if the proposed list of new, deleted, and revised diagnosis codes becomes final. The list of ICD-9 changes was recently posted to the CMS Website, and includes the final full set of changes that the agency will make to ICD-9 codes. After the new codes take effect on Oct. 1, CMS will only add new ICD- 9 codes on an emergency basis as it prepares to switch over the diagnosis coding system to ICD-10.

Seek Out Skin Cancer Changes

You’ll find a significant expansion to the 173.x (Other malignant neoplasm of skin) categories, including changes to 173.0x (…Skin of lip), 173.1x (Eyelid, including canthus), 173.2x (Skin of ear and external auditory canal), 173.3x (Skin of other and unspecified parts of face), 173.4x (Scalp and skin of neck), 173.5x (Skin of trunk, except scrotum), 173.6x (Skin of upper limb, including shoulder), 173.7x (Skin of lower limb, including hip), 173.8x (Other specified sites of skin), and 173.9x (Skin, site unspecified).

Among these changes, for example, you’ll find the following new codes to delineate various types of skin cancers:

173.60 —Unspecified malignant neoplasm of skin of upper limb, including shoulder
173.61 — Basal cell carcinoma of skin of upper limb, including shoulder
173.62 — Squamous cell carcinoma of skin of upper limb, including shoulder
173.69 — Other specified malignant neoplasm of skin of upper limb, including shoulder.

The changes in the other skin cancer categories referenced above follow this pattern, with the fifth digit of “0” referring to an unspecified malignant neoplasm, “1” denoting a basal cell cancer, “2” referring to a squamous cell carcinoma,” and “9” describing another...

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June 22, 2011

Coder's Cranium / General / Hot Coding Topics / Provider News

Improve Your Tennis Elbow Claims Score: Make Reach, Repair, and Reattachment Your Winning Strategy

Tactics help you recoup deserved pay for 24357-24359.
Tennis elbow claims faults can wreak havoc on your reimbursement for these services. But you can clean up your method if you can spot in the note how the surgeon reached the elbow tendon and whether the tendon was released or repaired. By doing so, you stand to gain your full earned pay for codes 24357, 24358, and 24359, which is $437.27, $514.74, and $647.59, respectively.
Review Structures Treated
When you are confident in your elbow anatomy knowledge, you’ll have a better chance of understanding where the operative note is directing you. The codes are simple and can easily be applied if you are reading correctly. “Coding these procedures became much easier when CPT condensed the codes from the previous five down to the current three,” confirms Heidi Stout, BA, CPC, COSC, PCS, CCS-P, Coder on Call, Inc., Milltown, New Jersey and orthopedic coding division director, The Coding Network, LLC, Beverly Hills, CA. The bones, –humerus above and the radius and ulna below– articulate in a manner to allow 180 degrees of movement that helps you use the upper limb for various functions.

The numerous muscles that originate and insert around the joint allow movement; particularly important is the bundle of extensors including the muscle extensor carpi radialis brevis (ECRB) that originates at the lateral epicondyle which is the lateral prominence of the humerus at the elbow joint. Repeated back movements of the wrist joint, as seen when playing tennis, can cause small micro tears in the tendon of origin and result in inflammation known as lateral epicondylitis or ‘tennis elbow.’ The term is highly deceptive, though; the condition affects non-athletes as well, and is not solely confined to tennis players. As the pathology progresses, the damaged tendon(s) may rupture and...

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June 17, 2011