Part B Insider (Multispecialty) Coding Alert

DIAGNOSIS CODING:

CDC Readies New ICD-9 Codes

Published on Thu May 22, 2003

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Starting in October, you could have a whole new way to look at Pap smear aftercare, hepatitis, and several other conditions.

The National Center for Health Statistics sent a host of proposed ICD-9 diagnosis codes to the Centers for Medicare & Medicaid Services and expects the final list of new ICD-9s to be published in the Federal Register within two weeks, says Amy Blum, medical classification specialist with the NCHS.

Part of the Centers for Disease Control and Prevention, the NCHS is responsible for creating the codes and diagnoses portion of the ICD-9-CM, Blum says. Then it's up to CMS to decide what to cover and how to classify the codes for reimbursement purposes.

Many of the proposed new ICD-9 codes were unveiled at a Coordination and Maintenance Committee meeting April 3. If CMS approves the proposals, the codes that will be broken out into more specific codes include:

070.6, Unspecified viral hepatitis with hepatic coma, to be split into two codes for unspecified hepatitis C and other unspecified hepatitis

070.7, Unspecified viral hepatitis without mention of hepatic coma, to be split similarly

453.4, a new category for "Other venous embolism and thrombosis," will be further broken out into three codes, depending on the position on the leg

V58.4, Postsurgical aftercare, will give rise to V58.44, Aftercare following organ transplant

V72.3, Routine gynecological exam, will be broken out into two new codes for follow-up Pap smears following an abnormal result on an earlier Pap smear

477, Allergic rhinitis, and contact dermatitis, will be broken out into codes addressing allergies to animal dander

V84, Genetic susceptibility to disease, will give rise to new codes addressing predispositions to breast cancer, prostate cancer and others

621.3, Endometrial cystic hyperplasia, will give rise to a more specific code for that complaint and one for endometrial adenomatous hyperplasia

530.8, Diseases of esophagus, will now include codes for infection of esophagostomy and mechanical complication of esophagostomy

252.0, Hyperparathyroidism, will be split between primary and secondary, and CMS will create separate codes for renal and nonrenal hyperparathyroidism

V69, Lifestyle problems, will include a code for sleep deprivation.

The new codes also help to identify women who have undergone circumcision, which may impact pregnancy and delivery. Pregnancy test codes would be expanded to include unconfirmed and negative results. A code for nonspecific findings on examination of blood would include a sub-code for elevated C-reactive protein.

And the proposal would modify 622.1, Dysplasia of cervix, to add several disorders to the description of the code, including human papilloma-virus. It would also make several revisions to the descriptions for the codes involving abnormal Pap smears.

Blum said that last October's ICD-9 included new aftercare codes to avoid overcounting injuries and to address the fact that earlier aftercare codes didn't give enough information on things like the site of a fracture or the fact that an injury was still healing.

Editor's note: The new proposal is at http://www.cdc.gov/nchs/data/icd9/agendaapril03.pdf.