Each October brings new changes in ICD-9 diagnosis coding – changes you should be aware of if you want to avoid claim denials. Here are highlights of the changes that may be most relevant to family physicians.
Diagnosis code 256.3, “Other ovarian failure,” has been deleted and replaced with two new codes: 256.31, “Premature menopause,” and 256.39, “Other ovarian failure.”
Similarly, 793.8, “Nonspecific abnormal findings on radiological and other examination of body structure, breast,” has been deleted and replaced with the following three new codes:
793.80 Unspecified abnormal mammogram,
793.81 Mammographic microcalcification,
793.89 Other abnormal findings on radiological examination, breast.
Heart and lungs
The word “acute” has been added to 411.81, so it now reads, “Acute coronary occlusion without myocardial infarction.”
Additionally, when you use “0” as the fifth digit with codes in the 493 category (asthma), you will now be indicating “without mention of status asthmaticus or acute exacerbation or unspecified.” Previously, a fifth digit of “0” in this category simply indicated “without mention of status asthmaticus.” Code 493.00, for example, will now specify “Extrinsic asthma without mention of status asthmaticus or acute exacerbation or unspecified.”
Diagnosis code 564.0, “Constipation,” has been deleted and replaced with the following four new codes:
564.00 Unspecified constipation,
564.01 Slow transit constipation,
564.02 Outlet dysfunction constipation,
564.09 Other constipation.
A new code, 530.12, has also been added for “Acute esophagitis.”
Here are a few new V codes of note:
V10.53 Personal history of malignant neoplasm, renal pelvis,
V83.01 Asymptomatic hemophilia A carrier,
V83.02 Symptomatic hemophilia A carrier.
Also, V70.7 has been simplified from “Examination for normal comparison or control in clinical research” to “Examination of participant in clinical trial.”
The code for “Acute laryngitis,” 464.0, has been deleted in favor of two new codes: 464.00, “Acute laryngitis, without mention of obstruction,” and 464.01, “Acute laryngitis, with obstruction.”
There are also new codes for sunburns and stress fractures:
692.76 Sunburn of second degree,
692.77 Sunburn of third degree,
733.93 Stress fracture of tibia or fibula,
733.94 Stress fracture of the metatarsals,
733.95 Stress fracture of other bone.
Don’t learn the hard way
As always, these represent just some of the ICD-9 code changes. Be sure to consult your new ICD-9 manual for all the changes that may be relevant to your practice. Reviewing these changes now may save you the trouble of learning them the hard way – through claim denials.
UPDATED FPM CODING TOOLS AVAILABLE
Family Practice Management’s popular ICD-9 coding references have been updated to comply with the ICD-9 codes in effect from Oct. 1, 2001 to Sept. 30, 2002. At www.aafp.org/fpm/icd9.html, you’ll find “ICD-9 Codes for Family Practice 2001–2002: The FPM Short List.” This list of about 600 codes was developed by Donald Spencer, MD, MBA, and Allen Daugird, MD, MBA, both family physicians and clinical associate professors at the University of North Carolina, Chapel Hill, and Philip S. Whitecar, MD, assistant professor of family medicine at Wright State University, Dayton, Ohio.
Drs. Spencer, Daugird and Whitecar also updated the expanded list. “The FPM Long List,” which features about 1,500 codes, can be downloaded from the FPM Web site at www.aafp.org/fpm/icd9.html.