ED Coding and Reimbursement Alert

Question: A patient presents to the ED physician complaining of pain during urination. During the course of a level-three E/M, the ED physician orders a urinalysis. Notes indicate that the patient had "micro hematuria." Is there a code for "micro hematuria?" Nebraska Subscriber Answer: The condition your physician describes is microscopic hematuria, which means that the blood in the patient's urine was not plainly visible. There is no specific code for this condition -- yet. If you are filing this claim before the end of September, you should report 99283 (Emergency department visit for the evaluation and management of a patient, which requires these three key components: an expanded problem-focused history; an expanded problem-focused examination; and medical decision making of moderate complexity) with 599.7 (Hematuria) appended to represent the patient's condition. Coming soon: Beginning Oct. 1, you-ll be expected to use the ICD-9 2009 codes, which don't include 599.7. The new code set for hematuria in ICD-9 2009 consists of: - 599.70 -- Hematuria, unspecified - 599.71 -- Gross hematuria - 599.72 -- Microscopic hematuria. New way: If you are filing this claim on or after Oct. 1, report 99283 with 599.72 appended to represent the patient's condition. Remember: There is no longer a grace period for new ICD-9 codes, so 599.7 won't fly after Sept. 30. For more info on ICD-9 2009 and how it will affect your ED, check out Vol. 11, Nos. 8, 9, and 10 of ED Coding Alert.