Eli's Hospice Insider

Published on Sun May 24, 2009 PDF

Some of the new codes may help you with ICD-10.

With everything else going on in the hospice payment and compliance world, don't forget that you have to keep up with ICD-9-CM updates that go into effect Oct. 1.

The Centers for Medicare & Medicaid Services has issued 141 new diagnosis codes for you to use starting Oct. 1. Most of the new codes will offer additional specificity to existing diseases, which can help you code more accurately.

A Plethora of New Codes You'll find new codes in most categories, including in oncology and orthopedics. The 2010 codes alsoexpand the 799.2 (Nervousness) section, with new codes for irritability (799.22), impulsiveness (799.23), and demoralization and apathy (799.25), among others.

"The new fifth digit ICD-9 codes can be used to report emotional and/or behavioral symptoms," says Marvel J. Hammer of MJH Consulting in Denver. If the emotional/behavioral signs and symptoms are inherent in an established diagnosis, you should not code them separately, however, Hammer adds.

"Additionally, these new codesparallel the ICD-10-CM codes found in the R45.X Symptoms and Signs Involving Emotional State section, allowing for easier mapping when providers convert to ICD-10 in 2013," Hammer says.

Oncology: One of the biggest ICD-9 expansions in the new set of codes deals with cancer diagnoses, with the following codes indicative of what you'll see effective Oct. 1:

• 209.31-209.36 -- Merkel cell carcinoma

• 209.70-209.74 -- Secondary neuroendocrine tumor

• 285.3 -- Antineoplastic chemotherapy induced anemia. This new code is a good one to be aware of because you used to have to use two codes to convey that the patient's anemia was due to chemotherapy, says Charlotte Lefert, RHIA, a health information management consultant based in Madison, Wis.