Posted on 04. Jun, 2009 by in Hot Coding Topics
A 453.x facelift will require you to hunt for more specific upper extremity codes.
Oct. 1 and implementation of the 2010 ICD-9 codes may still be a few months away, but CMS is offering a sneak peak at the added, deleted, and revised codes that cardiology coders will need to know. Keep your focus on the embolism and thrombosis codes so you’ll be ready to report them from day one.
Phlebitis Coding Frustrations? Join the Club
In 2009, your coding options are 451.0-451.9 (Phlebitis and thrombophlebitis) and 453.0-453.9 (Other venous embolism and thrombosis).
Problem: “‘Thrombophlebitis’ is a term that is now rarely used, due to the lack of clinical significance of ‘phlebitis,’” according to Patrick Romano, MD, MPH, professor of medicine and pediatrics at University of California at Davis, in his “Phlebitis and Thrombophlebitis” presentation to the ICD-9 Coordination and Maintenance Committee. He presented the proposal on behalf of the Agency for Healthcare Research and Quality.
Coding has paralleled this reduced use of “thrombophlebitis,” with 453.x (embolism and thrombosis) reported much more frequently than 451.x (phlebitis and thrombophlebitis), Romano said.
An expansion of the 453.x (embolism and thrombosis) range should help you choose codes more in line with current clinical terminology. As described below, the new codes offer options based on location as well as the acute vs. chronic nature of the problem.
Need for Upper Extremity Codes Revealed
Trend: “Increasing use of PICC lines, central catheters, tunnel dialysis catheters, and wired cardiac devices has increased incidence of DVT [deep venous thrombosis] in thorax and upper extremities, typically the axillary, subclavian, [and] brachiocephalic vein,” Romano said.
But ICD-9 2009 doesn’t offer the same specificity in upper extremity codes...
- Free updates on CPT, ICD-9, HCPCS, Medicare, NCCI edits, and ICD-10.
- Discounts on 3rd party offers