H1N1 Prompts Urgent ICD-9-CM Code Expansion

As part of the Addenda for 2010 ICD-9-CM, a new code for swine flu has been created, and the code for bird flu revised:

487 Influenza
Influenza caused by unspecified influenza virus

Excludes: Hemophilus influenzae [H. influenzae]:
influenza due to 2009 H1N1 [swine] influenza virus (488.1)
influenza due to identified avian influenza virus (488.0)
influenza due to identified novel H1N1 influenza virus (488.1)

488 Influenza due to certain identified influenza viruses

Excludes: influenza caused by unspecified influenza viruses (487.0-487.8)
488.0 Influenza due to identified avian influenza virus
Avian influenza
Bird flu
Influenza A/H5N1

488.1 Influenza due to identified novel H1N1 influenza virus
2009 H1N1 [swine] influenza virus
Novel 2009 influenza H1N1
Novel H1N1 influenza
Novel influenza A/H1N1
Swine flu

These codes were created to provide data capture for the novel H1N1 influenza A virus (swine flu), first identified in April after the March 2009 ICD-9-CM Coordination and Maintenance Committee meeting and the World Health Organization (WHO) declared a global pandemic alert on June 11.


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25 Responses to “H1N1 Prompts Urgent ICD-9-CM Code Expansion”

  1. Caroline says:

    When can we use the new codes?

    Thank you,

  2. Chastity Cecil says:

    Yes, I need to know when we can this code as well.


    Chastity Cecil, CPC

  3. Handmaid says:

    October 1st, 2009

  4. brenda says:

    Yes, when should we begin to use these codes?

  5. Rhonda Prando says:

    New Diagnosis Codes are Effective October 1, 2009.

  6. desiree says:

    people are being diagnosed with swine flu now. would there not be an exception to use these codes asap? if the H1N1 called for an urgent code update, why would we need to wait til oct to use it?

  7. Glenn Singer says:

    Will this be included in the new printed manuals, or as an addendum page?

  8. Mark Smith says:

    As a new “coder-to-be” I am taking the test on the 27th of this month. Is this going to be something that I need to be including in my studies? (That is, is there a possiblilty that there will be something about this on our test?)

  9. greg says:

    I doubt ther this will be on the test, it’s not in the 2009 ICD-9 book. It doesn’t hurt to write it in the book though.

  10. jonvieve says:

    Every year all ICD-9 code additions/deletions/changes take effect on October 1st.
    On October 1, 2009 all codes in the 2010 ICD-9 will be effective. If you are taking your CPC Exam before October 1, 2009 you use the 2009 book. If you take the CPC Exam after 10/1/09 you need to purchase the 2010 ICD-9.

  11. Diana says:

    There’s approximately 2 1/2 months before the new ICD 2010 codes are released; however, since H1N1 has been classified as a “pandemic”, wouldn’t it be beneficial to release these codes prior to the effective date, 10/1/2009, so the condition can be accurately classified? We hear of a new cases daily.

  12. BARBIE says:


  13. Katy says:

    Pretty good post. I just came by your blog and wanted to say
    that I have really liked reading your posts. Anyway
    I’ll be subscribing to your blog and I hope you write again soon!

  14. cowcoder says:

    One of the drawbacks to the portion of HIPAA that covers Transaction and Code Sets Standards is that code set updates have to follow a regular schedule. For ICD-9-CM, the updates can only go into effect on October 1 of any given year and April 1 of the following year (although I have yet to see these “mid-year” April updates since HIPAA was passed.

  15. brad says:

    It will be in the printed manuals.

  16. brad says:

    It will be in the new manuals.

  17. Lisa says:

    What do doctors use for a code now for H1N1? My insurance claim was rejected because there was no code for this test.

  18. ip says:

    Why bother identifying special? Insurance companies in NY pay less than the cost of the test. Practioner’s follow the same protocol. Patients don’t get any different care if it is H1N1 or regular flu.

    The only one to benefit is the CDC for the extra cost and time.

  19. Jennifer says:

    Can I use this for presumed H1n1?

  20. renee says:

    If the provider records “suspected or possible or probable avian or novel H1N1 influenza (H1N1 or swine flu),” the appropriate influenza code from category 487 should be assigned.

  21. Deborah says:

    My understanding is that medicare has there own Administration code for the N1H1 and you should use it to code the Administration also their is no charge for this shot. Just the Administration fee

  22. Deb says:

    Should patients diagnosed with Influenza A be coded as 487.1 or 488.0?

  23. Lola says:

    Yes, I would like to know what code to use for the Influenza A. I came up with 488.02 is this correct?

  24. Beatrice says:


  25. Beatrice Hamil says:

    can H1N1 FLU BE REPORTED WITH 488.12 TO reimbursement

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