Archive for 'ICD-10'

News You Can Use: Don’t Hold Your Breath For ICD-11 as an ICD-10 Alternative

Posted on 22. Aug, 2012 by .


Here’s why CMS will ignore the AMA’s endorsement.

Last month, you checked out the ICD-11 possibility in \”AMA ‘Evaluating ICD-11′ As ICD-9 Alternative\” in the Volume 2, Number 7 ICD-10 Coding Alert – but others are scoffing at that idea.

Despite endorsement of a direct move to ICD-11 from the American Medical Association and others, don’t be surprised to see CMS ignore that advice. \”It took the U.S. eight years to adapt the WHO version of ICD-10 and create ICD-10-CM for use in this country,\” the American Health Information Management Association (AHIMA) counters in a recent article. (more…)

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Breaking News: Supreme Court Ruling on ‘ObamaCare’ Got You Wondering About ICD-10? We Have Answers

Posted on 09. Aug, 2012 by .


Best bet: Keep up your implementation plans.

In the wake of the Supreme Court’s recent ruling, you may be wondering how this affects your ICD-10 implementation. We’ve got the lowdown.

Recall the History of ICD-10

The requirement to move toward the electronic format of 5010 and the ICD10 code set was actually part of the HIPAA 1996 under the Clinton administration. (Health Insurance Portability and Accountability Act of 1996), says Suzan Berman, CPC, CEMC, CEDC, Senior Director of Physician Services at Healthcare Revenue Assurance Associates based out of Plantation, Florida.

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ICD-10: Take a Straight BMI Path from ICD-9 to ICD-10

Posted on 27. Jul, 2012 by .


Adult codes still dominate.

With all the press on childhood obesity, ICD-10 still provides greater granularity for measures of adult body mass index (BMI). In fact, the new code set provides a near-perfect one-to-one correspondence with ICD-9 codes.

Don’t forget: CMS has announced a proposed implementation date change from Oct. 1, 2013 to Oct. 1, 2014 for the new diagnosis code set.

Expect Easy Crosswalk

Some ICD-9 to ICD-10 conversions require additional documentation, or even classifying conditions differently than you’ve been used to. That’s not the case for BMI measures. (more…)

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ICD-10: 413.9 Will Divide Into ‘Other’ and ‘Unspecified’ ICD-10 Options

Posted on 12. Jul, 2012 by .


Don’t assume – let the inclusion notes guide your angina code choice.

When ICD-10 replaces ICD-9, you’ll need to know whether cardiac angina falls under “other” or “unspecified” angina pectoris. Here are some tips to keep your coding compliant.

The diagnosis: Angina pectoris refers to chest pain or discomfort caused by coronary heart disease.

ICD-10 Coding Alert  Not sure whether cardiac angina will fall under “other” or “unspecified”
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ICD-10: 669.7x Cesarean Delivery Codes Merge into 1 Code in ICD-10

Posted on 28. Jun, 2012 by .


Hint: You must include an outcome code.

When you report the cesarean delivery code in ICD-10, you’ll have one option – but make sure you include these additional codes as well.

A cesarean delivery means the physician makes one or more incisions through the mother’s abdomen and uterus to deliver one or more babies.

Currently, you will choose a cesarean delivery code from one of two options:

  • 669.70, Cesarean delivery, without mention of indication, unspecified as to episode of care or not applicable
  • 669.71, Cesarean delivery, without mention of indication, delivered, with or without antepartum condition.

ICD-10: (more…)

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ICD-10: 453.42 Splits Into Tibial, Other, and Unspecified ICD-10 Options

Posted on 13. Jun, 2012 by .


 You’ll need to know the leg involved to choose the best DVT code.  

 Coding for deep vein thrombosis (DVT) will get a lot more detailed under ICD-10. Here’s what you can expect.   

Embolism is the obstruction of a vessel by a clot or foreign substance (such as plaque or fatty deposits). Thrombosis is obstruction by a blood clot. The codes featured here are specific to deep vessels, and that means the codes are appropriate for DVT. The codes are also specific to acute cases, as opposed to chronic.   

ICD-9-CM code:   

 453.42, Acute venous embolism and thrombosis of deep vessels of distal lower extremity

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ICD-10: Change to R04.0 for Epistaxis Under ICD-10

Posted on 09. May, 2012 by .


Plus: Remember right/left modifiers according to payer policy.

Under ICD-9 rules, you have just one code to report for nosebleeds, whether a patient comes to your office with active bleeding or has nosebleeds so frequently he wants to learn whether something more complex might be happening to cause the problem. Your go-to diagnosis is 784.7 (Epistaxis), which describes all nosebleeds that aren’t caused by a more complex condition.

ICD-10 changes: When the ICD-10 transition takes place, you’ll benefit from a one-to-one crosswalk. Code R04.0 will be your new diagnosis code when reporting nosebleeds.

Documentation: (more…)

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ICD-10: Prepare Now for Multiple Diagnosis Choices for Secondary Parkinsonism ICD-10 will expand options for more specificity

Posted on 25. Apr, 2012 by .


Anesthesia providers sometimes rely on underlying conditions such as Parkinson’s disease to help justify why a patient needs anesthesia. ICD-10 brings several new Parkinson’s diagnosis options to consider, so accurate coding will depend on how many details your providers include in their documentation.

Currently, ICD-9-CM has two diagnoses for Parkinson’s disease, and each qualifies the types of conditions included:

  • 332.0 (Paralysis agitans) encompasses idiopathic or primary forms of Parkinsonism or Parkinson’s disease, or Parkinson’s NOS.
  • 332.1 (Secondary Parkinsonism) includes neuroleptic-induced Parkinsonism or Parkinsonism due to drugs.
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ICD-10 – CMS Proposes One-Year Delay for ICD-10

Posted on 12. Apr, 2012 by .


Don’t count on the delay quite yet, coding expert warns.    

You may have been wondering how to make contingency plans ever since HHS Secretary Kathleen Sebelius announced on Feb. 16 that the government would be delaying the deadline for ICD-10 diagnosis coding, but failed to designate a new implementation date.    

Now CMS has nailed down its proposed new deadline: Oct. 1, 2014. That’s one year later than the October 2013 date currently in effect. CMS announced the proposal on April 9, and noted that it’s part of a rule that also includes other HIPAA-related provisions.    

“Many provider groups have expressed serious concerns about their ability to meet the Oct. 1, 2013, compliance date,” CMS says in a release. “The proposed change in the compliance date for ICD-10 would give providers and other covered entities more time to prepare and fully test their systems to ensure a smooth and coordinated transition to these new code sets.”    

Provider Community Offers Mixed Reviews    

Some practices are breathing a sigh of relief that they have an extra year to switch to ICD-10. But others say that they are frustrated that their intensive ICD-10 preparation is getting stalled at this late date.    

The American Medical Association, which was a vocal proponent of an ICD-10 implementation delay, cheered the news. “The American Medical Association and physicians across the nation appreciate that CMS has proposed delaying the ICD-10 implementation date to October 1, 2014,” said Peter W. Carmel, MD, the AMA’s president. “The postponement is the first of many steps that regulators need to take to reduce the number of costly, time-consuming regulatory burdens that physicians are shouldering.”    

Don’t write the new ICD-10 deadline in pen quite yet, though. “ICD-10-CM is NOT delayed until October 1, 2014,” coding expert Lisa Selman-Holman notes on her blog. The new deadline is merely a proposal. “The healthcare industry has the opportunity to comment on the proposal and THEN CMS can publish a final rule,” notes Selman-Holman with Selman-Holman & Associates and CoDR — Coding Done Right.  

The billions this delay is expected to cost providers may stymie the delay. “Only time will tell,” Selman-Holman says.  You have 30 days to comment on the CMS proposal, which can be viewed in the Federal Register at To submit your comments, visit and refer to “CMS-0040-P.”  

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ICD-10: Prostate Cancer Coding Mirrors ICD-9 Neoplasm Table Structure

Posted on 28. Mar, 2012 by .


Hint: You’ll apply the same PIN rules even when the codes change.   

If you don’t have any trouble using the ICD-9 neoplasm table, you shouldn’t have a hard time transitioning to ICD-10 neoplasm codes.   

For example, here’s how the two code set options for malignant prostate cancer coding compare:   

ICD-9: Under ICD-9, your prostate neoplasm options include:   

  • Primary: 185, Malignant neoplasm of prostate
  • Secondary: 198.82, Secondary malignant neoplasm of genital organs
  • Ca in Situ: 233.4, Carcinoma in situ of prostate.

If you report prostatic intraepithelial neoplasia (PIN), you should use 233.4 for PIN III. But you should use 602.3 (Dysplasia of prostate) for PIN I or PIN II. 

ICD-10… Your ICD-10 options offer up familiar terms:  

  •  Primary: C61, Malignant neoplasm of prostate
  • Secondary: C79.82, Secondary malignant neoplasm of genital organs
  • Ca in Situ: D07.5, Carcinoma in situ of prostate.

 If you report PIN III, you should use D07.5. For PIN I or PIN II, you should use N42.3 (Dysplasia of prostate) instead.

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