Ob-Gyn Coding Alert

"The Health Care Financing Administration (HCFA) recently announced new and revised ICD-9 codes for 2001. With several changes affecting ob/gyns, practices are wise to start reviewing their patient encounter forms to keep them up-to-date. Although the changes are effective Oct. 1, 2000, many payers will wait until Jan. 1, 2001, before processing claims using the new codes. Check with your payers about when they will start accepting the new codes.

The changes help to clarify language that in some cases was a little cloudy. The new codes also bring more definitive diagnosis options to the physician, says Susan Callaway-Stradley, CPC, CCS-P, an independent coding consultant and educator based in North Augusta, S.C.

Code Revisions and Clarifications

Numeric ICD-9 codes represent infectious and parasitic diseases. V codes are for factors other than disease or injury that influence health (i.e., pregnancy).

564.1 The language of this code for irritable colon has changed. The new nomenclature reads irritable bowel syndrome, the most frequently used term for this condition.

791.9 This change clears up some confusion by referencing pyuria (urine that contains pus) to a single code, 791.9. Previously, the alphabetic index referenced this condition to 599.0 (urinary tract infection, site not specified) (under the heading of pus) and code 791.9 (other nonspecific findings on examination of urine) (under the heading of pyuria).

646.8x This code is to be used in place of 655.8x (other known or suspected fetal abnormality, not elsewhere classified) when diagnosing the condition uterine size-date discrepancy. The code to report this service will be 646.8x (other specified complications of pregnancy). ICD-9 also has added the descriptor uterine size-date discrepancy to the code in the tabular index.

656.3x In the current ICD-9 book, the term fetal distress, NOS is listed among the conditions excluded from 656.3x. If the physician indicated the term fetal distress without mention of fetal metabolic acidemia, 656.8 (other specified fetal and placental problems) would have been the correct code. This was an error that has been corrected. If a physician indicates a diagnosis of fetal distress or fetal metabolic acidemia, 656.3x (fetal distress) should be reported.

663.8x Code 663.5x (the fifth digit denotes the current episode of care), vasa previa, included velamentous insertion of the umbilical cord as an inclusion term in the tabular index. The American College of Obstetricians and Gynecologists (ACOG) pointed out that this was not accurate. For 2001, the reference to this condition is deleted from 663.5 and added to 663.8x (other umbilical cord complications) because it more accurately describes the conditions diagnostic category.
[...]