ICD-9 Update:
ICD-9 Update:
Published on Tue Oct 01, 2002
Prepare Now for Revisions in the New Year Although the New Year is still months away, some payers will begin to implement revised ICD-9 guidelines for 2003 as early as Oct. 1, 2002. Proposed revisions to ICD-9, initially announced in the May 9, 2002, Federal Register (Vol. 67, No. 90, pp. 31627-31631), include nearly 150 new diagnosis codes, as well as 19 code deletions. All payers must accommodate the changes on or before Jan. 1, 2003. Many new codes reflect a trend toward greater diagnosis specificity. For example, five codes (459.30, 459.31, 459.32, 459.33 and 459.39) have been added to describe chronic venous hypertension without complications, with ulcer, with inflammation, with ulcer and inflammation, or with other complication. The largest category of new codes focuses on pediatric and obstetric diagnoses. For example, there are now 10 codes, 633.00-633.91, to describe various abdominal, tubal, ovarian and ectopic pregnancies. New codes of particular interest to general surgery practice include:
040.82 Toxic shock syndrome
277.02 Cystic fibrosis with pulmonary manifestations
277.03 with gastrointestinal manifestations 277.09 with other manifestations
414.06 Coronary atherosclerosis of coronary artery of transplanted heart
414.12 Dissection of coronary artery
428.20 Unspecified systolic heart failure
428.21 Acute systolic heart failure
428.22 Chronic systolic heart failure
428.23 Acute on chronic systolic heart failure
428.30 Unspecified diastolic heart failure
428.31 Acute diastolic heart failure
428.32 Chronic diastolic heart failure
428.33 Acute on chronic diastolic heart failure
428.40 Unspecified combined systolic and diastolic heart failure
428.41 Acute combined systolic and diastolic heart failure 428.42 Chronic ... 428.43 Acute on chronic ...
443.21 Dissection of carotid artery
443.22 of iliac artery
443.23 of renal artery
443.24 of vertebral artery
443.29 of other artery
445.01 Atheroembolism, upper extremity 445.02 lower extremity 445.81 kidney 445.89 other site 454.8 Varicose veins of the lower extremities, with other complications
459.10 Postphlebitic syndrome without complications
459.11 with ulcer
459.12 with inflammation
459.13 with ulcer and inflammation
459.19 with other complication
995.91 Systemic inflammatory response syndrome due to infectious process without organ dysfunction
995.92 with organ dysfunction
995.93 Systemic inflammatory response syndrome due to non-infectious process without organ dysfunction
995.94 with organ dysfunction
998.31 Disruption of internal operation wound
998.32 external operation wound The approximately 150 code additions to ICD-9 for 2003 also include 40 new V codes, of which 31 are "aftercare" codes for patient care following surgery, e.g., V58.43, Aftercare following surgery for injury and trauma. Payer response to the new codes is as yet uncertain. Other codes in this category that general surgeons may use include:
V58.71 Aftercare following surgery of sense organs, NEC V58.73 of the circulatory system, NEC
V58.74 of the respiratory system, NEC [...]
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