NCHS Updates ICD-9 Guidelines

The Centers for Disease Control and Prevention’s (CDC’s) National Center for Health Statistics (NCHS) posted updates Aug. 5 to the ICD-9-CM Official Guidelines for Coding and Reporting. These guidelines for diagnosis coding are effective Oct. 1.

Changes are in bold text:

In section I (A) (8): “The word “with” should be interpreted to mean “associated with” or “due to” when it appears in a code title, the alphabetic index or an instructional note in the tabular list.”

In section I (C) (7), the first sentence under Hypertensive Chronic Kidney Disease now reads: “Assign codes from category 403, Hypertensive chronic kidney disease, when conditions to category 585 or code 587 are present with hypertension.”

In section I (C) (8), under Influenza Due to Certain Identified Viruses,  the guidelines instruct you to “Code only confirmed cases of avian influenza (codes 488.01-488.02, 488.09, Influenza due to identified avian influenza virus) or novel H1N1 influenza virus (H1N1 or swine flu, code 488.11-488.12, 488.19).”

In section I (C) (11), under Fetal Conditions Affecting the Management of the Mother, the guidelines update the descriptor for category 656 to read “Other known or suspected fetal and placental problems …”

In section I (C) (18), under Classification of Factors Influencing Health Status and Contact with Health Services (Supplemental V01-V91), code V91.99 is added to the list of codes to deal with encounters for circumstances other than a disease or injury. This V code is added to several subsequent chapters, as well. In the same chapter, under Status, the guidelines clarify: “Status codes indicate that a patient is a carrier of a disease, has the sequelae or residual of a past disease or condition, or has another factor influencing a person’s health status.” Under Obstetrics and Relate Conditions, in the same chapter, the descriptor for code 646.3 Recurrent pregnancy loss is added. Also in this chapter, the descriptor for Miscellaneous V Code V07 is updated to read “Need for isolation and other prophylactic or treatment measures; Except V07.5X, Use of agents affecting estrogen receptors and estrogen levels.”

Nonspecific V code descriptor updates include:

V49.81 Asymptomatic postmenopausal status (age-related) (natural)
V49.86 Do not resuscitate status
V49.87 Physical restraints status

The complete guidelines are available on the NCHS website.

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