Need More ICD-9 Codes for Grafts, Cardiomyopathy?
Published on Fri Aug 01, 2003
Solution on the Way
If you're looking for a better way to specify graft occlusion for heart transplant patients or a more complete list of long-term drug use codes, your wait will be over soon. Thanks to new ICD-9 codes that take effect Oct. 1, you'll have what you need to improve your signs and symptoms coding for these and other conditions.
CMS unveiled the new diagnosis codes, some of which affect cardiology practices, in the May 19 Federal Register. The ICD-9 codes are updated on Oct. 1 of each year, says Patricia E. Brooks, RHIA, a member of CMS' ICD-9-CM Coordination and Maintenance Committee.
Once the new codes are in effect, "we try to make sure that everyone in the billing office is up to date on the changes," says Rebecca Sanzone, CPC, billing manager for Midatlantic Cardiovascular Associates of Baltimore. Although some of the new diagnosis changes won't affect her office, the more information she can share with billers and physicians on those changes that will affect them, the better, she says. Occluded Grafts and Transplants Get the Fifth Degree The new diagnostic codes make several significant changes to the acute and chronic ischemic heart disease codes, revising descriptors for occluded arteries in transplants or grafts and adding a new code for atherosclerosis in bypass grafts.
Code 414.06 (Of coronary artery of transplanted heart) will add the descriptor "native" to the phrase "of coronary arteries" to distinguish between atherosclerosis in native and non-native grafts. And for occluded bypass grafts in heart transplant patients, you will report new code 414.07 (Of bypass graft [artery] [vein] of transplanted heart) after Oct. 1. Cardiology coders will welcome the specificity of these codes, particularly 414.07, which is just for occluded grafts, says Terri Davis, CPC, coding supervisor for the University of Oklahoma College of Medicine. She adds that she expects to link these new codes to heart catheterization procedure codes.
Adding 414.07 changes the exclusion descriptions for several codes. The exclusions for 411.81 (Acute coronary occlusion without myocardial infarction) will be obstruction without infarction due to atherosclerosis (414.00-414.07) and occlusion without infarction due to atherosclerosis (414.00-414.07) rather than obstruction without infarction due to atherosclerosis (414.00-414.06) and occlusion without infarction due to atherosclerosis (414.00-414.06). So, you should not report the new bypass graft code (414.07) with 411.81.
Codes 440.8 (Atherosclerosis, of other specified arteries) and 447.6 (Arteritis, unspecified) will also exclude 414.07. Make the Most of Glucose Intolerance Test Changes If your cardiologist uses glucose intolerance testing to diagnose diabetes, you can report three new testing codes beginning Oct. 1: 790.21 (Impaired fasting glucose), 790.22 (Impaired glucose tolerance test [oral]) and 790.29 (Other abnormal glucose).
Glucose intolerance testing to treat patients before they become diabetic is [...]
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