Terrorism hit the annual ICD-9 update, with new codes for anthrax and other potential biological and chemical agents.
Effective Oct. 1, 2002, with a grace period until Jan. 1, 2003, the new codes provide more specific diagnoses, as well as explicit health status (V) and external cause (E) codes for terrorism. Other new ICD9 Codes report lab test results pertaining to infections such as West Nile virus and genetic carrier status for diseases such as cystic fibrosis. You can access a complete list of ICD-9 code changes on the Internet at
http://www.cms.hhs.gov/medlearn/icd9code.asp. Report Anthrax Infection,Exposure Status Last year's anthrax threat pointed up the inadequacy of the current system for reporting possible terrorist exposure. Although ICD-9 codes existed for confirmed cases of anthrax infection (022.0 cutaneous, 022.1 pulmonary, 022.2 gastrointestinal, 022.3 septicemia, 022.8 other specified manifestations, and 022.9 unspecified), specific codes for exposure status and cause of exposure were nonexistent.
ICD-9 2003 allows reporting three levels of exposure status:
1) Confirmed exposure: The U.S. Centers for Disease Control and Prevention (CDC) last year instructed labs to report general code 795.3 (Nonspecific positive culture findings) for a positive anthrax nasal swab confirming exposure. ICD-9 2003 adds new code 795.31 (Nonspecific positive findings for anthrax) with the definition "positive findings by nasal swab." "Use this code when patients with a positive nasal swab do not exhibit confirmed disease symptoms reportable to 022.x," says Laurie Castillo, MA, CPC, CPC-H, CCS-P, member of the national advisory board of the American Academy of Professional Coders (AAPC) and president of Physician Coding and Compliance Consulting in Manassas, Va. 2) Exposure: General code V01.8 (Contact with or exposure to other communicable diseases) last year reported individuals with contact or exposure to anthrax. Now a subcategory, V01.8, includes two new subclassification codes for 2003: V01.81 (Anthrax), and V01.89 (Other communicable diseases). Report V01.81 when the patient has known exposure to anthrax, but it has not yet been confirmed through a positive nasal swab, Castillo says.
3) Suspected exposure, not found: Report evaluation for suspected anthrax exposure with new code V71.82 (Observation and evaluation for suspected exposure to anthrax) rather than the general code available last year: V71.8 (Observation and evaluation for other specified suspected conditions). For suspected exposure to other organisms, report new code V71.83 (Observation and evaluation for suspected exposure to other biological agent). ICD-9 instruction specifies that the V71 category "is to be used when persons without a diagnosis are suspected of having an abnormal condition, without signs or symptoms, which requires study, but after examination and observation, is found not to exist."
To indicate the cause of exposure to chemical or biological agents, ICD-9 2003 adds new category E979 (Terrorism). For biological weapons exposure, report new [...]
