Upcoming ICD-9 Changes Affect Family Practices
Published on Sun Sep 01, 2002
From abnormal Pap smears to fracture follow-ups many of the upcoming ICD-9 changes will affect family practices. Knowing about the changes will help you revise your encounter forms and prepare to code accurately so you can avoid denials. CMS' new and revised diagnosis codes take effect Oct. 1, 2002. Here's the lowdown on what to expect. 1. Abnormal Paps Occasionally, in a family practice the result of a patient's Pap smear is abnormal and she must come in for a follow-up for another Pap. In the past, coders had one diagnosis code to use 795.0 (Nonspecific abnormal Papanicolaou smear of cervix). But this code did not identify the reason for the abnormality. Now, says Kent Moore, manager of Health Care Financing and Delivery Systems for the American Academy of Family Physicians (AAFP) in Leawood, Kan., the new ICD-9 codes provide greater specificity to identify abnormal Pap smears. "Using a fifth digit to code abnormal Paps was not previously required," he says.
The new abnormal Pap smear codes include:
795.00 Nonspecific abnormal Papanicolaou smear of cervix, unspecified 795.01 Atypical squamous cell changes of undetermined significance favor benign (ASCUS favor benign) 795.02 Atypical squamous cell changes of undetermined significance favor dysplasia (ASCUS favor dysplasia) 795.09 Other nonspecific abnormal Papanicolaou smear of cervix. 2. Signs and Symptoms The new signs and symptoms codes that FPs will find most useful are those describing crying infants. "It's not unusual to see crying infants, and quite often after the history and exam you still don't have a specific diagnosis to explain their symptoms," says A. Clinton MacKinney, MD, MS, the AAFP representative on the AMA CPT Advisory Committee and medical director at HealthPartners Central Minnesota Clinics in St. Cloud, Minn. "These new codes will allow the physician to code these symptoms more accurately, instead of having to use the general signs and symptoms code."
Code 780.9 (Other general symptoms) has been subdivided into three new codes:
780.91 Fussy infant (baby) 780.92 Excessive crying of infant (baby) 780.99 Other general symptoms. 3. Aftercare V Codes Billing for follow-up may get easier with the new and improved aftercare codes. When you report V54.81, use an additional code (i.e., V43.60-V43.69) to identify the joint replacement site, Moore says.
New subcategories for orthopedic aftercare include:
V54.10-V54.19 Aftercare for healing traumatic fracture V54.20-V54.29 Aftercare for healing pathologic fracture V54.81 Aftercare following joint replacement V54.89 Other orthopedic aftercare V58.42 Aftercare following surgery for neoplasm V58.43 Aftercare following surgery for injury and trauma V58.71-V58.78 Aftercare following surgery to specified body systems, not elsewhere classified. ICD-9 also added a new code for patients with oxygen tanks because they have chronic obstructive pulmonary disease (COPD) or emphysema. Code V46.2 (Other dependence on machines, [...]
