Pediatric Coding Alert

Avoid these soon-to-be-taboo codes this October If you've been looking for a clearer way to indicate postnasal drip, generalized pain, or torsion of the epididymis, ICD-9 2007 ends your search with several new diagnosis codes, which take effect Oct. 1.
 
Although you'll confront more than 200 new codes this fall, we'll save you time by identifying the changes that will have the biggest impact on your coding. One pediatrician gives you the skinny on the new ICD9 Codes that he plans to use in his general pediatric practice . "Many more might occasionally be used (once or twice a year), but for those infrequent times, it isn't worth clogging a cheat sheet/quick reference plaque," says Charles A. Scott, MD, FAAP, pediatrician at Medford Pediatric & Adolescent Medicine PA in Medford, N.J.
 
Reminder: HIPAA does not allow a grace period for implementing the new codes, so you need to know the newbies and update your superbills by Sept. 30. Benefit From Codes for Postnasal Drip, Bronchospasm Acute postnasal drip can be a big cause of irritation for patients, says Heather Corcoran, coding specialist at CGH Billing in Louisville, Ky.
 
Example: A child has a postnasal drip, but the pediatrician doesn't diagnose the patient with allergies. You now end up with a potential payment problematic "other" code (784.9, Other symptoms involving head and neck). But ICD-9 2007 will allow you to pinpoint the symptom with specific code 784.91 (Postnasal drip). This is a good diagnosis for general pediatric practices to add to their cheat sheet, Scott says. The "other" code will also morph into a fifth-digit code: 784.99 (Other symptoms involving head and neck).
 
Another new code your practice may find useful is 519.11 (Acute bronchospasm). ICD-9 2007 separates out acute bronchospasm and identifies it as a separate and distinct condition, says Carol Pohlig, BSN, RN, CPC, at Hospital of the University of Pennsylvania in Broomall. That's a big change from the current two-tiered approach.
 
"You have to identify it as a general acute component of another condition (such as acute exacerbation of bronchiolitis, emphysema, bronchitis, COPD, etc.) or lump it into the general category (519.1, Other diseases of trachea and bronchus) if no other disease process is present," Pohlig says.
 
Don't forget: To avoid denials when you do have to use the other code, starting Oct. 1 add a fifth digit of 9 to the current "other code." In other words, 519.1 will become 519.19.

Better Support Services With New Symptom Codes The ICD-9 manual will also allow you to pinpoint "generalized pain." Now you have to lump this symptom under generic code 780.99 (Other general symptoms). Starting in October, you'll be able to use 780.96 (Generalized pain), says Susan Vogelberger, CPC, CPC-H, CMBS, [...]