Radiology Coding Alert

From pressure ulcers to suspected ob troubles, we've got you covered Breast disorder diagnosis codes are getting a boost in 2009 with six new codes, and there are even more diagnoses you need to be on alert for. Part of the radiology coding challenge is the broad range of diagnoses you have to be able to recognize and code accurately. The big changes to headache and oncology diagnoses aren't the only ICD-9 updates that affect you. We've analyzed the preliminary ICD-9 2009 list from CMS and narrowed down the field to these nine additional changes you'll be using next year. 1. Peek at New Pressure Ulcer Options Your radiologist may assess forming or long-standing pressure ulcers using ultrasound or other modalities. New fifth digits will add stage specificity to your coding, says Jackie Miller, RHIA, CPC, senior coding consultant for Coding Strategies Inc. in Powder Springs, Ga.: • 707.20 -- Pressure ulcer, unspecified stage • 707.21 -- Pressure ulcer, stage I • 707.22 -- Pressure ulcer, stage II • 707.23 -- Pressure ulcer, stage III • 707.24 -- Pressure ulcer, stage IV. ICD-9 2008 classifies all stages together with a few site-specific codes in the 707.0x range (Decubitus ulcer). But the new codes should help facilities that use coded records to guide quality improvement. 2. Add New Breast Disorder Codes to Your Toolbox You'll have new codes for breast conditions such as ptosis (611.81, Ptosis of breast), hypoplasia (611.82, Hypoplasia of breast), capsular contracture of breast implant (611.89) and other specified disorders of the breast (611.89). Also, be on the look out for 612.0 (Deformity of reconstructed breast) and 612.1 (Disproportion of reconstructed breast). 3. Tackle New 5th-Digit Hematuria Options If you need to indicate that a radiologist performed a test because a patient has blood in the urine, or "hematuria," you'll have new fifth-digit options to describe this condition. Look to codes 599.70 (Hematuria, unspecified), 599.71 (Gross hematuria) and 599.72 (Microscopic hematuria). Lesson: If your encounter form now lists 599.7 (Hematuria) as an option, you will start getting denials as of Oct. 1 unless you remember to list one or more of the new five-digit codes for this condition, says Guadalupita, N.M.-based independent coding consultant Melanie Witt, RN, CPC-OGS, MA. 4. Get a Grip on New Graft-Vs-Host Disease Codes If you provide services for patients with graft-versus-host disease, be sure you catch these new immune mechanism disorder codes: • 279.50 -- Graft-versus-host disease, unspecified • 279.51 -- Acute graft-versus-host disease • 279.52 -- Chronic graft-versus-host disease • 279.53 -- Acute on chronic graft-versus-host disease. Watch for: Interventional radiologists may increasingly begin using catheters to direct steroids to the patient's affected organs, so you may see more chances to use [...]