Pediatric Coding Alert

Pediatricians will welcome the new and revised ICD9 codes for 2003, which add specificity and provide solutions for many previously overlooked pediatric diagnoses. The new codes go into effect on Oct. 1, 2002. Many payers may not have the new codes entered in their systems until they become mandatory on Jan. 1, 2003, so check with your carriers before filing claims with the new diagnoses. Many codes reflect a trend toward greater specificity. Codes 770.8, 771.8, 779.8 and 780.9 now require a fifth digit, as detailed below. Fussy Baby,Crying Codes Allow Accurate Reporting Most important, pediatricians now have a specific diagnosis for fussy infant. Coders previously recommended 789.00 (Abdominal pain, unspecified site) for abdominal pain because a fussy baby usually has colic (Pediatric Coding Alert, April 2003, page 27.) Pediatricians can now access 780.91 (Fussy infant [baby]). In addition, pediatricians can report visits for excessive crying of an infant with new code 780.92 (Excessive crying of infant [baby]). ICD-9 2003 removes the four-digit reporting of 780.9 (Other general symptoms) and requires a fifth digit of 9 to report other general symptoms. Respiratory Codes Offer Greater Specificity CMS creates a fifth digit for 770.8 (Other respiratory problems after birth). Apnea, cyanotic attacks and respiratory failures are now individually defined rather than grouped into one code. The new diagnoses include: 770.81 Primary apnea of newborn 770.82 Other apnea of newborn 770.83 Cyanotic attacks of newborn 770.84 Respiratory failure of newborn. Code 770.8 is renumbered as 770.89 (Other respiratory problems after birth). Infections Are Further Defined Similarly, 771.8 now requires a fifth digit, which describes specific, newborn infections rather than encompassing sepsis, urinary tract infections (UTI) and bacteremia into one code. Code 771.8 (Other infection specific to the perinatal period) is now 771.89. Individual diagnoses are now defined as: Sepsis 771.81 (Septicemia [sepsis] of newborn) UTI 771.82 (Urinary tract infection of newborn) Bacteremia 771.83 (Bacteremia of newborn). Neonatal Bradycardia,Tachycardia Dxs Are Created The ICD-9 tabular list previously instructed coders to use 763.83 (Abnormality in fetal heart rate or rhythm, unspecified as to time of onset) for bradycardia, newborn. ICD-9 2002 allow pediatricians to assign specific neonatal diagnosis for: Bradycardia 779.81 (Neonatal bradycardia) Tachycardia 779.82 (Neonatal tachycardia). Codes 779.81 and 779.82 appear under "other specified conditions originating in the perinatal period." For 2002, this definition correlated to 779.8. This code is now 779.89. Short Gestation Codes Are Expanded The 765 series (Disorders relating to short gestation and unspecified low birthweight) adds a new category 765.2x (Weeks of gestation). The fifth digit describes the amount of completed weeks of gestation from unspecified to 37 completed weeks of gestation, broken down as follows: 765.20 Unspecified weeks of gestation 765.21 Less than 24 completed weeks of gestation [...]