ICD-9 2010 takes some of the gray areas out of coding gray matter woes.
The diagnosis code for "other conditions of brain" has changed from 348.8 to 348.89. And you know the ICD-9 rule: When a code has a fifth digit, reporting four digits won't cut it. Here's what you need to know about these ICD-9 changes.
Out With 348.8, In With 348.8x
Diagnosis 348.8 (Other conditions of brain) is invalid for services performed on or after Oct. 1, but ICD-9 2010 introduces a new fifth-digit replacement: 348.89. The descriptor remains the same, so you'll be able to use it for the same circumstances as 348.8 when ICD-9 doesn't offer a more specific option.
Example:
You might use the "other" code "when there is 'something' found, but it's not yet defined as a neoplastic process or other definitive process," says
Lisa Nelson, CPC, a medical coding specialist in Wisconsin. Nelson says you might use the "other" code when the physician documents a "brain lesion" or "mass" prior to pathological diagnosis.
And you may code "something like flat EEG, brain death, or cerebral calcifications" using 348.89, says Kathryn Gemmell, RHIT, in the physician coding department of St. Luke's Hospital in Bethlehem, Pa. Notes following 348.89 also specify it's appropriate for cerebral fungus.
348.81 added:
The addition of a fifth digit to this category made way for 348.81 (
Temporal sclerosis), which applies to hippocampal and mesial temporal sclerosis, according to ICD-9 notes. Temporal sclerosis is associated with seizures, and you may see physicians order MRIs to evaluate these patients.
Check it out:
For more on ICD-9 2010 changes affecting you, see
Radiology Coding Alert, Vol. 11, No. 9. Remember, you must report ICD-9 2010 codes for services on or after Oct. 1, 2009. Using invalid codes will result in denials.
