Test Yourself: ICD-9 2010 for Ob-Gyn Coders

Posted on 29. Nov, 2009 by sanjay.aikat.

Is your ob-gyn practice using the new codes correctly? 3 quick questions say for sure.

This year, ICD-9 2010 brought new hyperplasia, mammogram, and fertility preservation codes. In some cases, these codes simply expanded on existing options, and it’sup to you to spot when you should report the new versus old alternatives. Dig in to these three scenarios to see if you can choose the proper code for services performed on or after Oct. 1.

Scenario 1: Pick Apart New Puerperal Options Your ob-gyn documents “a puerperal infection,” a bacterial illness following childbirth. How would you report this?

A. 670.0 — Major puerperal infection
B. 670.1x [0,2,4] — Puerperal endometritis
C. 670.2x [0,2,4] — Puerperal sepsis
D. 670.3x [0,2,4] — Puerperal septic thrombophlebitis
E. 670.8x [0,2,4] — Other major puerperal infection

Scenario 2: Don’t Overlook 671 Category Notes You’re reporting a code from the 671 (Venous complications in pregnancy and the puerperium) category, but you need to provide what additional information? Select one of the following options:

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Are You Up For ICD-9 2010? Quick Quiz Says For Sure

Posted on 17. Sep, 2009 by .

Surgery Coders: These 5 questions reveal if you need an ICD-9 workout.

October 1 is just around the corner, and that means you’ll soon need to be up and running with the latest ICD- 9 changes. Are you wondering where you should focus your time and energy?

Time-saver: This quiz on the new codes and the basics of diagnosis coding will help you determine whether you’re on the right track, or if you should work on your 2010 diagnosis coding know-how.

Question 1: Once the 2010 ICD-9 changes go into effect on Oct. 1, what diagnosis code should you report when your surgeon documents “chronic venous embolism and thrombosis of superficial veins of left arm”?

A. 453.71

B. 453.8

C. 453.81

D. None of the above.

Question 2: True or false: You can never report a V code as the primary diagnosis.

Question 3: Which of the following is ICD-9 2010 diagnosis code you’ll report for a patient with an unspecified neoplasm?

A. 239.8

B. 239.81

C. 239.89

D. V10.90.

Question 4: True or false: You can never report an E code as the primary diagnosis.

Question 5: Your surgeon sees a patient with a personal history of a malignant neuroendocrine tumor, which affects the surgeon’s medical decision making for treatment. To support the higher-level medical decision making, what ICD-9 2010 diagnosis code will you report?

A. V10.90

B. V10.91

C. V53.50

D. All of the above.

Don’t miss the ASC Coding & Billing Conference this December 6-8 in Orlando.

Click ‘read more’ to check your answers.

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ICD-9 2010: More Coding Options for Brain Injury

Posted on 12. Aug, 2009 by .

Check out V80.01 and V80.09 for special screenings.

The newest edition of ICD-9 changes goes into effect Oct. 1, so adjust your system to reflect some new diagnosis codes for special neurological screenings — and one that’s about to become invalid — to be sure your claims stay on par.

Extend ‘Other Conditions’ Dx From 348.8 to 348.89

Diagnosis 348.8 (Other conditions of brain) will be invalid starting Oct. 1, but ICD-9 2010 introduces a new fifth-digit replacement: 348.89. The descriptor remains the same, so you’ll be able to use it for the same circumstances as 348.8.

“I seldom used 348.8 because I do mostly surgery coding and use the final pathology report for diagnoses,” says Kathryn Gemmell, RHIT, in the physician coding department of Luke’s Hospital in Bethlehem, Pa. “Something like calcium deposits on the brain or brain death could be coded to 348.89.” You might also turn to 348.89 to show a brain problem not identified with a specific ICD-9 code, Gemmell adds.

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Urology Coder’s ICD-9 2010 Update

Posted on 27. Jul, 2009 by .

Get Ready Now for Urinary Diversion, Renal Disease Dx Changes in October

In just a few months, you’ll be faced with more than 350 ICD-9 changes. If you don’t incorporate the changes into your coding that day, your practice could face denials and lost revenue. There are 311 new, 22 invalid, and 45 revised ICD-9 codesthat take effect on Oct. 1, 2009.

Every dollar – and every productivity hour – counts these days, so we’ve scoured the diagnosis code changes for you. Here are 3 changes urology coders need to understand in order to code properly after Oct. 1.

Incorporate New Pouch Codes

If your urologist uses the intestines for urinary diversion, there are two new ICD-9 diagnostic codes that you should pay attention to. “These two codes may relate to problems with urinary diversions such as an ileal conduit or abdominal pouches, the Kock, Indiana, or Miami pouches,” says Michael A. Ferragamo MD, FACS, clinical assistant professor of urology, State University of New York, Stony Brook.

Join Dr. Ferragamo for his urinary diversion reimbursement audio training session.

You can use new ICD-9 code 569.71 (Pouchitis) for an infection of the diversionary bowl reservoir. For other diversionary problems you’ll be able to use new code 569.79 (Other complications of intestinal pouch).

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Diagnostic Radiology ICD-9 Code Update: New Mammo Code 793.82

Posted on 08. Jul, 2009 by .

New code 793.82 shakes up the whole 793.x range in 2010.

The switch to ICD-9 2010 is only a few short months away; preparing now for a crucial change in diagnostic imaging will put you ahead of the game.

Remember: ICD-9 2010 codes will be appropriate for services performed on or after Oct. 1, 2009.

Dense breasts may require testing beyond a mammogram to confirm no malignancies, and the request for an appropriate code to describe this resulted in 793.82 (Inconclusive mammogram), according to the ICD-9 Committee’s September 2008 meeting agenda.

“The new code may help get insurance companies to pay for additional testing,” says Cheryl Scott, CPC, CPC-H, CCS, CCS-P, with HealthTexas in Dallas. “Prior to the 2010 code, the choices were to bill it as screening or to code dense breasts as an ‘abnormality’” – which they aren’t, she says.

And precisely because these inconclusive mammogram findings are not “abnormal,” ICD-9 2010 will revise the 793.0-793.7 range so that “abnormal” findings aren’t a requirement for using these codes:

• 2009: Nonspecific abnormal findings on radiological and other examination of …

• 2010: Nonspecific (abnormal) findings on radiological and other examination of …

Codes 793.89 and 793.99 will have the same change, adding parentheses:

• 2010: 793.89 – Other (abnormal) findings on radiological examination of breast

• 2010: 793.99 – Other nonspecific (abnormal) findings on radiological and other examination of body structure.

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Orthopedic Coder’s ICD-9 Update: New Radius, Ulna Torus Fracture Codes

Posted on 03. Jul, 2009 by .

Come Oct. 1, you’ll no longer will you look to 832.0 for nursemaid’s elbow.

Does your orthopedist treat children’s arm problems with regularity? If so, then you may have three new ICD-9 codes to use as of Oct. 1. Take advantage of this sneak peak at the proposed orthopedic additions, and you’ll be ahead of your peers.

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Most of the new codes will offer additional specificity to existing diseases, which can help you code more accurately. Orthopedic coders, however, had hoped for a wider range of codes, says Leslie A. Follebout, CPC, COSC, PCS, coding manager at Peninsula Orthopaedic Associates in Salisbury, Md.

For instance, you may not celebrate the addition of fifth digits to existing codes 274.0 (Gouty arthropathy) and 453.8 (Other venous embolism and thrombosis of other specified veins). You may, however, find some brand-new additions.

Here’s 3 New Codes to Use in Pediatric Cases

If your orthopedist treats pediatric patients for fractures, then you’re used to applying forearm fracture ICD-9 codes. These constitute nearly half of all childhood fractures. ICD-9 2010 may bring you two new torus fracture options: 813.46 (Torus fracture of ulna [alone]) and 813.47 (Torus fracture of radius and ulna).

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