News Brief:
CMS Releases ICD-9 Codes for 2002
Published on Thu Nov 01, 2001
Effective Oct. 1, 2001, CMS (formerly HCFA) implemented an updated and revised ICD-9 coding guide. In the 2002 guide, CMS incorporated new and excluded codes, lengthened codes and added subcodes to existing entries to clarify diagnoses. Familiarity with these changes will help anesthesiologists and their coding and billing personnel in filing accurate claims.
"While the number of changes is about the same as last year, it seems that they have added more five-digit codes," says Barbara Johnson, CPC, MPC, a professional coder with Loma Linda University Anesthesiology Medical Group in California and a member of the National Advisory Board for the American Association of Professional Codes. "The fact is as codes become more specific, we have to be more specific."
Expanded Codes
Expanded codes can be found throughout ICD-9 2002. Areas such as evelopmental dislocation of joints, pathological fractures and abnormal mammography may be of special interest to anesthesiologists.
A new subcategory, 718.7[0-9] (developmental dislocation of joint), has been introduced. These codes define dislocations in an unspecified site, shoulder, upper arm, forearm, hand, pelvic region and thigh, lower leg, ankle and foot, other specified sites, and multiple sites. Note that the subcategory excludes congenital dislocation of hip (754.30-754.35) and traumatic dislocation of hip (835.00-835.13).
Expanded definitions are new also for pathological fracture (733.1), which now excludes stress fractures. These injuries are described with three new codes:
733.93 stress fracture of tibia or fibula (stress reaction of tibia or fibula)
733.94 stress fracture of the metatarsals (stress reaction of metatarsals)
733.95 stress fracture of other bone (stress reaction of other bone).
Coding for abnormal mammograms has also changed. Previously, abnormal mammogram findings were reported with 793.8. This code has been expanded to include 793.80 (abnormal mammogram, unspecified), 793.81 (mammographic microcalcification) and 793.89 (other abnormal findings on radiological examination of breast).
Revised Codes
In addition to expanded codes, a number of code revisions have been made. Johnson cites an example involving revised coding for asthma. "Category 493 contains a revised fifth-digit subclassification for '0'," she says. The new definition reads without mention of status asthmaticus or acute exacerbation or unspecified. In addition, 493.2 (chronic obstructive asthma) now contains an additional exclusion, acute bronchitis (466.0)." Corresponding changes to bronchitis codes exclude chronic obstructive asthma with acute exacerbation, which is represented by a new code, 493.22. Anesthesiologists should take note of these changes because they may perform intubation or other treatments for patients suffering from severe obstructions associated with these diseases.
Changes to V and E Codes
Although relatively few changes have been made to V codes that affect anesthesiology , Kelly Dennis, CPC, of Central Florida Anesthesia Associates of Leesburg, Fla., and president of the Florida Anesthesia Administrators Association, suggests coders look at new code V10.53 (personal history of malignant [...]
