Home Health & Hospice Week

Pay attention to diabetes, long-term drug use coding changes.

Keeping up on diagnosis coding will mean learning a raft of new codes that take effect this year.

Oct. 1 may seem like a distant date, but the ICD-9 Coordination and Maintenance Committee has already been at work determining which new ICD-9 codes will make their debut that day. The committee considered adding new ICD-9 codes for 10 conditions during its March meeting.

Two of these conditions--secondary diabetes and long-term drug use--are especially likely to affect home health agencies' coding, predicts coding consultant Lisa Selman-Holman with Denton, TX-based Selman-Holman & Associates. Here are some details:

• Secondary diabetes. Right now, you have no way to report diabetes resulting from another condition affecting the pancreas, such as pancreatitis or cystic fibrosis, explains Amy Blum, medical classification specialist with the National Center for Health Statistics, which creates the ICD-9 codes. You're not allowed to use the current diabetes codes for secondary diabetes, so you're stuck with an unlisted code.

Key: If secondary diabetes receives its own category, it will parallel the codes for primary diabetes. This will be the most significant change to the ICD-9 book "as far as how many codes it will create and how it will affect coders," Blum says. • Long-term drug use. The ICD-9 book already includes codes for aspirin, anticoagulants and half a dozen other types of drugs. The committee is considering adding codes for tamoxifen, steroids and a couple more medications, says Blum. The Department of Health and Human Services makes final decisions on code revisions, the Centers for Medicare & Medicaid Services says in its summary report.

Timeline: The committee received no request in September to implement any proposed codes April 1, so any new codes will take effect Oct. 1, CMS says. 

Note: For more information on diagnosis coding, see Eli's Home Health ICD-9 Alert at www.elihealthcare.com/spec_health_icd-9.htm or by calling 1-800-874-9180.