Oncology & Hematology Coding Alert

Watch for these 2 still-to-come notes and index changes.

As long as the list of 2010 ICD-9 revisions is, it isnt the full story, of course. Index and note changes can affect your coding, too, even when related code descriptors dont change. Here are two potential changes that may be coming your way.

1. The ICD-9 committee received a request to create a code for pre-chemotherapy ultrasounds. The committee decided that because V codes are reasons for encounter codes, not procedure codes, it would be inappropriate to create such codes (www.cdc.gov/nchs/data/icd9/agendaMa08.pdf).

Compromise: ICD-9 may add an inclusion note instructing you to assign V72.83 (Other specified preoperative examination) for pre-chemotherapy exams.

2. Patrick S. Romano, MD, MPH, proposed transfusion reaction code changes (such as 999.87, Other specified transfusion reaction) on behalf of the Agency for Healthcare Research and Quality. The goal was to separate ABO incompatibility reactions from minor antigen reactions. An alternate proposal was to reindex minor antigen reaction terms to 999.89 (Other transfusion reaction). Theyre currently indexed to 999.6 (ABO incompatibility reaction).

The CMS release did not include new code 999.87 -- indicating ICD-9 did not adopt the new codes -- so before you code a transfusion reaction using ICD-9 2010, youll want to check the index to be sure youre choosing the appropriate code for minor antigen reactions.

Resource: You can find presentation slides at www.cdc.gov/nchs/about/otheract/icd9/maint/classifications_of_diseases_and1.htm.