Part B Insider (Multispecialty) Coding Alert

Published on Sat Apr 03, 2010 PDF

Get ready for new jaw pain, BMI codes, among others.

If you've got high hopes that you'll benefit from many new ICD- 9 codes starting this fall, CMS delivers, with over 130 new diagnosis codes debuting on Oct. 1. CMS published the full listing of codes in a 1,000+ page Federal Register file, but we've reviewed the list, and it offers a few surprises.

Over one-third of the new codes can be found in the "V" code section, which describe "supplementary classification of factors influencing health status and contact with health services," according to the ICD-9 manual.

"They've expanded the body mass index (BMI) codes to demonstrate higher BMIs with five new codes," notes Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CENTC, CHCC with CRN Healthcare Solutions in Tinton Falls, NJ.

Whereas in the past, you had just one V code to represent a BMI index over 40 (V85.4), the new edition of ICD-9 will offer additional categories, ranging from a BMI of 40.0 to 44.9 (V85.41) through a BMI of 70 and over (V85.45).

"BMI has become an important health tool, and those codes will also provide more data," says Susan Vogelberger, CPC, CPC-H, CPC-I, CMBS, CCP-P, CEO of Healthcare Consulting & Coding Education, LLC. "There are seven vital signs that count for the constitutional bullet in the E/M review of systems coding, and there are those who are of the opinion that BMI should be an eighth option, especially in bariatrics and orthopedics/sports medicine."

If that eighth bullet does gain traction and come into play for coders, the new V codes could help considerably.

Pain code: You'll find new code 784.92 (Jaw pain) effective Oct. 1. According to notes made by the ICD-9-CM Coordination and Maintenance Committee in Sept. 17, 2009, "it was suggested to somehow differentiate temporomandibular joint disorders and this code, perhaps using an excludes note."