ED Coding and Reimbursement Alert

Consider these new diagnosis codes to best capture your ED services. Although everyone is anticipating the transition to ICD-10 in October of 2013, we can't forget about some key updates to ICD-9 2012 that take affect Oct. 1 that will affect your ED claims. Resource: A file providing complete information on 2012 changes to the diagnosis part of ICD-9-CM is posted on CMS's webpage at https://www.cms.gov/icd9providerdiagnosticcodes/07_summarytables.asp. Heed Dementia Adjustments To illustrate, consider these ICD-9 code changes for dementia which more clearly indicates how the disease impacted the care provided in the ED including inability to obtain the normal history or physical exam requirements: New sub 294.2 Dementia, Unspecified Excludes mild memory disturbances, not amounting to dementia (310.89) New code 294.20 Dementia, unspecified, without behavioral disturbance Dementia NOS New code 294.21 Dementia, unspecified, with behavioral disturbance Aggressive behavior Combative behavior Violent behavior Use additional code where applicable, to identify wandering [...]