CODING & DOCUMENTATION
Fam Pract Manag. 2017 Sep-Oct;24(5):34.
Author disclosure: no relevant financial affiliations disclosed.
- ICD-10 code updates for Oct. 1
- Billing for the new influenza vaccination
- Diagnosis coding for hypertension and heart failure
- Medicare payment for telemedicine home visits
ICD-10 code updates for Oct. 1
What changes to ICD-10 codes for 2017–2018 will affect family medicine the most?
About 750 total changes will be implemented on Oct. 1, 2017 – many fewer than in the last annual update. New codes that may be important to family medicine include the following:
A04.71, “Enterocolitis due to clostridium difficile, recurrent,”
A04.72, “Enterocolitis due to clostridium difficile, not specified as recurrent,”
E11.10, “Type 2 diabetes mellitus with ketoacidosis, without coma,”
E11.11, “Type 2 diabetes mellitus with ketoacidosis, with coma,”
P83.81, “Umbilical granuloma,”
R06.03, “Acute respiratory distress,”
Multiple N63 codes specifying the laterality and area of the breast (e.g., left breast or lower inner quadrant) in which an unspecified lump or nodule is found.
The full ICD-10 code update files are available online.
Billing for the new influenza vaccination
Does Medicare Part B cover the new RIV4 influenza vaccine?
Yes. For claims with dates of service on or after July 1, 2017, Medicare Part B covers code 90682, “Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use.” Seasonal pricing for this and other flu vaccines is available online. Note that the Part-B deductible and coinsurance do not apply to claims paid for flu vaccine products or administration. Use code G0008 to report flu vaccine administration in addition to the code for the vaccine product when billing Medicare.
Diagnosis coding for hypertension and heart failure
Should I assign separate ICD-10 codes for my patients who have both hypertension and heart failure, or should I default to code I11.0?
If your documentation supports that the heart failure is not due to hypertension, report
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