Archive for 'ICD-10'

ICD-10: CMS Clarifies Some Rules Surrounding Usage of ICD-10 Codes

Posted on 10. Sep, 2014 by .


Review guidelines on how to code when the diagnosis isn’t definite.

Implementation of ICD-10 may have been deferred to October 2015, but the Centers for Medicare & Medicaid Services (CMS) has stepped up guidance to help you prepare for the new diagnosis coding system. Recently the agency released a transmittal that should help you understand how you’ll report these codes when insurers start requiring them next year.

CMS issued Transmittal 3020 on Aug. 8, and it announces revisions to the official ICD-10 Coding Guidelines which put them more in line with the current ICD-9 rules. For example, CMS revised the ICD-10 regs to now say, “Do not code diagnoses documented as ‘probable,’ ‘suspected,’ ‘questionable,’ ‘rule out,’ or ‘working diagnosis’ or other similar terms indicating uncertainty. Rather, code the condition(s) to the highest degree of certainty for that encounter/visit, such as symptoms, signs, abnormal test results, or other reason for the visit.”

Here’s why: (more…)

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ICD-10: Determine Esophagitis Status When Coding Reflux

Posted on 27. Aug, 2014 by .


Starting next year, the single code for reflux expands into two separate choices.

Esophageal reflux can occur at all ages, but the condition “is common and often overlooked in children,” according to the Pediatric/Adolescent Gastroesophageal Reflux Association.  If you see this common condition in your practice, get to know how the coding will change next year under ICD-10.

ICD-9 Coding Rules: Under the ICD-9 code set, if you see a pediatric patient and diagnose her with esophageal reflux, you currently report 530.81 (Esophageal reflux) for the visit.

ICD-10 Changes: (more…)

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ICD-10: CMS Solidifies 2015 Date, Clarifies Testing

Posted on 13. Aug, 2014 by .


The agency also offers an alternative claim submission method.

Although the latest ICD-10 implementation date was proposed as Oct. 1, 2015, it wasn’t set in stone — until now. On July 31, CMS announced that the 2015 date has been finalized as the deadline for ICD-10 implementation. After Sept. 30, 2015, ICD-9 codes will no longer be accepted.

Because the date has already been pushed back several times, many providers are already prepared for the transition, but should continue to stay on top of ICD-10 changes and updates as the 2015 date gets closer. (more…)

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ICD-10: Don’t Wrestle With Which Wrist Sprain to Report in 2015

Posted on 23. Jul, 2014 by .


Tip: You’ll need to specify the joint and the side.

When a patient presents with a sprain of the wrist, this means the patient presents with an injury to the ligaments of the wrist.

Currently, you have these ICD-9 options:

  • 842.00, Sprain of unspecified site of wrist
  • 842.01, Sprain of carpal (joint) of wrist
  • 842.02, Sprain of radiocarpal (joint)(ligament) of wrist
  • 842.09, Other wrist sprain

ICD-10-CM: When ICD-10 hits, you’ll have numerous more options: (more…)

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ICD-10: Follow a Familiar Process to Code Surgical Complications in ICD-10

Posted on 09. Jul, 2014 by .


Question: Our patient was referred to home care following a cholecystectomy due to acute cholecystitis. She also has a history of breast cancer and is taking Tamoxifen prophylactically. She’s had some problems with urinary retention after surgery and one of her surgical wounds is dehisced. We will be discontinuing the indwelling catheter and instructing her on how to use an intermittent catheter. How should we code for this patient in ICD-9 and how will our coding change for ICD-10?

Florida Subscriber

Answer: Code for this patient as follows, (more…)

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ICD-10: Separate Out Sick Sinus Syndrome Under ICD-10 SSS and bradycardia options take the place of sinoatrial node dysfunction code.

Posted on 25. Jun, 2014 by .


A quick look may show you how ICD-10 divvies up sinoatrial node dysfunction code 427.81 into two distinct codes. But you’ll need to dig a little deeper to see how 427.81’s “includes” list gets assigned under the new code set.

ICD-9-CM Code

  • 427.81, Sinoatrial node dysfunction

ICD-10-CM Code (more…)

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ICD-10: Don’t Overlook Different Code Choices for Alcohol Induced Psychosis in ICD-10

Posted on 11. Jun, 2014 by .


Question: Our psychiatrist recently saw a patient for psychosis. The patient had a chronic history of alcoholism and a history of alcohol use for the past 15 years. Our clinician noted a family history of alcohol use. There is no family history of psychiatric problems. The diagnosis our clinician arrived at was alcohol induced psychosis. What codes should I use to report this diagnosis?

Maryland Subscriber

Answer: (more…)

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ICD-10: Code 733.11 Expands to 85 Choices in ICD-10

Posted on 28. May, 2014 by .


Remember 7th digit for encounter.

How much more can you say about a disease-related humeral fracture (733.11, Pathological fracture of humerus)?

A lot, apparently, based on the fact that ICD-10 provides 85 different codes for that condition.

Simplify: Don’t get too overwhelmed by that number — you really just need to know five codes, but the number explodes to 85 because each of the five codes requires a sixth digit for right/left/unspecified, and each of those fifteen codes requires a seventh digit (there are six choices) to describe the encounter.

Here are the five base codes you need to know: (more…)

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2015 IPPS Cites ICD-10 Implementation Date as Oct. 1, 2015

Posted on 13. May, 2014 by .


Here’s what to do about end-to-end ICD-10 testing.

Although it was over a month ago that Congress voted to extend the ICD-10 implementation date, CMS has been strangely mum on the topic, which was puzzling to many providers who were eager to find out when they’ll have to start using ICD-10 codes. However, a new proposed rule seems to suggest that the implementation date was pushed back by exactly one year.

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Don’t Get Mixed Up Over Mixed Hearing Loss Coding ICD-10 won’t cover all options, so you could turn to ‘unspecified’ more often.

Posted on 23. Apr, 2014 by .


Many of your current diagnosis codes will be expanded or more specific when you transition to ICD-10 in October, but a big exception for otolaryngology is with conductive hearing loss.

ICD-9 options: In ICD-9, conductive hearing loss diagnoses are specific to the location within the ear under category 389.0x (Conductive hearing loss). For example, a few of your current choices include:

  • 389.01 – Conductive hearing loss, external ear
  • 389.02 – Conductive hearing loss, tympanic membrane
  • 389.03 – Conductive hearing loss, middle ear
  • 389.05 – Conductive hearing loss, unilateral
  • 389.06 – Conductive hearing loss, bilateral. (more…)

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