Medicare Compliance & Reimbursement

Think CPT contained the only errors? Wrong: ICD-9 has mistakes you should note, too. To err is human, and the American Medical Association (AMA) admits its mistakes by releasing several errors published in its 2009 ICD-9 manual that you'll need to correct to ensure you're on the cutting edge. Since you've had over a month to peruse the 2009 ICD-9 manual, you may have noticed glitches. Clear Up 5th Digit Confusion No 5th digit needed: Some coders have discovered a "5th digit" requirement next to code 339.3 (Drug induced headache, not elsewhere classified) in the manual. Rest assured, however, that this notation was an error on the publisher's part. The AMA instructs that 339.3 "Is a valid four-digit code." Same goes for chemical exposure: You can also scrap the "5th digit" requirement for new code V87.2 (Contact with and [suspected] exposure to other potentially hazardous chemicals). Only four digits are required for this code. Wrong 5th digit published: Another puzzler was the inclusion of the fifth digit box preceding category 535, Gastritis and Duodenitis. The box in the ICD-9 manual notes that fifth digit indicator 0 describes "without mention of obstruction," while a fifth digit of 1 notes, "with obstruction." However, you should change these descriptors to the following: • 0 -- Without mention of hemorrhage. • 1 -- With mention of hemorrhage. "Since most of the codes in the 535 series require a fifth digit, it's important for us all to make this correction in our ICD-9 manuals now to avoid problems down the road," says Heather Corcoran with CGH Billing. 5th digit required: In other cases, the ICD-9 manual failed to inform readers that a fifth digit was required on certain codes. For instance: You'll need to add a fifth digit to code 581.8 (Nephrotic syndrome, with other specified pathological lesion in kidney). Index Includes Errors The ICD-9 errata sheet also asks you to change several code references in the manual's index. For instance, if you look up "headache" (784.0), you'll find "tension" as one of the listed options. In the manual, it refers to a tension headache as code 307.81. You should change this reference to 307.10. To read the full list of ICD-9 errors, visit the AMA Web site, which can be found at http://www.ama-assn.org/ama/pub/category/13282.html.