Wiki New Lung/Pulmonary Nodule Coding

[Rockie88]

In the new ICD-9-code book, lung nodule can use one of two codes. If you start with Nodule, lung, solitary you get 793.11. If you go to Nodule, solitary, lung you get 518.89. What is the difference and when do I use one or the other. Same with Nodule, pulmonary solitary. Aren't pulmonary and lung the same thing?

 

[johnmeyer]

You're right that pulmonary and lung are basically the same thing; it's just a difference in words.
I looked up both codes and this is what I found....
I couldn't actually find 793.11 in the 2011 book, but I did find 793.1, which is used when your provider finds something during a diagnostic procedure, but he/she is not sure what he/she has found. It's listed under "abnormal findings." If you code this, you should expect your provider will want to do more testing.
518.89 would be used when your provider is diagnosing an actual lung disease, but the disease is not classified anywhere else in the coding book like broncholithiasis or calcification of the lung.
I hope this helps you out.

 

[dpeoples]

This is a good question. I thought I would bump this to see if more coders would weigh in.
There seems to be a contradiction in the ICD9 2012 edition.

under nodule
lung, solitary (518.89 is crossed out)
solitary 793.11
multiple 793.19

(yet furter down under nodule)

solitary, lung 518.89 (not crossed out)

thoughts anyone?

 

[LTibbetts]

I believe that for the 793.1x codes, you need the doctor to specifically doument that they found an abnormalty in the lung x-ray exam. The code description for 793 in the ICD-9 book specifically states "nonspecific abnormal findings on radiologic or other examination of body structure". So, if the doc says they see what they think may be a nodule on the x-ray, or some other nonspecific description of what they see, then go with the 793 code set. If they officially diagnosis a positive finding for a lung nodule, then use the 51889. Look closer at the ICD-9 code book descriptions and that might help. Every situation is obviously unique and documentation is everything!

As far as the new code for multiple nodules....thank goodness they finally added that!! Almost everytime I see this on a note, it is almost always more than one solitary nodule, so this code is definitely needed!!