Home Health ICD-9/ICD-10 Alert

Texas Subscriber

Answer: Report 488.81 (Influenza due to identified novel influenza A virus with pneumonia) to describe your patient's condition, says , says Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, HCS-O, consultant and principal of Selman-Holman & Associates and CoDR -- Coding Done Right in Denton, Texas. In the past, you most likely would have used 487.0 (Influenza with pneumonia), but that code didn't specify the nature of influenza A.

You'll also need to add a code to specify the type of pneumonia, such as viral pneumonia (480.0-480.9), pneumococcal pneumonia (481), bacterial pneumonia (482.0-482.9), pneumonia other specified (483.0-483.8), bronchopneumonia, or organism unspecified (485), Selman-Holman says. Query the physician for specifics because coding 486 (Pneumonia, organism unspecified) for your patient's pneumonia isn't appropriate.

The ICD-9-CM Coordination and Maintenance Committee has revised the influenza codes several years in a row now, which might make coding these conditions confusing. The most important fact to keep in mind when reporting influenza is to check the documentation for confirmation of the type that your patient has. When in doubt, check any lab reports or ask the physician to clarify.

Keep in mind: You'll also find revised diagnosis code descriptors for the H1N1 codes, as follows:

• 488.11 -- Influenza due to identified 2009 H1N1 influenza virus with pneumonia;
• 488.12 -- Influenza due to identified 2009 H1N1 influenza virus with other respiratory manifestations; and
• 488.19 -- Influenza due to identified 2009 H1N1 influenza virus with other manifestations.