Neurology & Pain Management Coding Alert
ICD-9 Update:
Prepare Now for 2003 Revisions Although the new year is still months away, some payers will begin to implement revised 2003 ICD-9 guidelines 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 and 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, respectively. 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 interest to neurology practice include:
The approximately 150 code additions to ICD-9 for 2003 also include 40 new V codes, of which 30 are "aftercare" codes for patient care following surgery (e.g., V58.72, Aftercare following surgery of the nervous system, NEC). Payer response to the new codes is as yet uncertain. With the possible exception of V58.72, however, neurologists are not likely to access these codes. Finally, 23 codes will receive revised descriptors for 2003. Of these, 15 involve categories 402.00-402.91 and 404.00-404.93 to describe hypertensive heart disease and hypertensive heart and renal disease, respectively which neurologists may occasionally access as secondary diagnoses. The changes include minor text revisions that will not affect how the codes are applied. Note: For a complete list of revisions to ICD-9 for 2003, visit pages 31627-31632 of the Federal Register at www.access.gpo.gov/su_docs/aces/aces140.html.
Codes 357.8 (Other inflammatory and toxic neuropathy) and 359.8 (Other myopathies), meanwhile, have been eliminated from ICD-9, replaced by the more specific, five-digit codes (359.81 and 359.89) listed above. The remaining 17 deletions follow the same pattern but are of minimal significance for neurology practices.
Neurology & Pain Management Coding Alert
- Know Your Limits:
Recognize Use and Frequency Guidelines for EDX Testing
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Medicare Does It Differently
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Cranial Nerve EMG
Test your coding knowledge. Determine how you would code this situation before looking at the [...] - ICD-9 Update:
Prepare Now for 2003 Revisions Although the new year is still months away, some payers [...] - Reader Question:
Minimal EEG
Question: What is the correct code to report minimal EEG for a comatose patient? Neurology [...] - Reader Question:
Neurophysiology Testing
Question: I have been receiving conflicting information on 95920. Can this code be used with [...] - Reader Question:
Less Than 24-Hour Monitoring
Question: The neurologist monitored a patient for localization of cerebral seizures, but not for a [...] - Reader Question:
Defining Muscle Groups for Injections
Question: What constitutes a "muscle group" as defined by trigger point injection codes 20552 and [...] - Statement of Ownership, Management, and Circulation
