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Thread: Question: ICD-9 code discrepancy

  1. #1
    Join Date
    Apr 2007

    Question Question: ICD-9 code discrepancy

    AAPC: Back to School
    My name is Marla Kelly, I am a CPC from Oklahoma. I think my clearinghouse which I submit electronic claims to and I have found a discrepancy with a code.

    I am trying to code 305.10.

    In the ICD-9 book the code is listed as 305.1 with a 5 and a circle around it in front of the code, which indicates a 5th digit is required. When going to the little box where one can choose the 5th digit it states; "The following fifth-digit subclassification is for use with codes 305.0, 305.2-305.9"

    Does this code require a 5th digit or is it a typo in the ICD-9 book? We are just needing some clarification to avoid a coding error or fraud.

    Thanks for any input on this matter.

    Happy New Year

    Marla Kelly CPC

  2. #2
    Join Date
    Apr 2007
    Lincoln, NE


    305.1 does not require a fifth digit.

    I know it looks confusing in the ICD-9 but if you'll note all the other 305 subcodes have (0-3) under them but 305.1 does not.
    I think there is a previous discussion about this code in an earlier thread.

    Julie, CPC

  3. #3
    Join Date
    Apr 2007
    Garden State Chapter, Cherry Hill, NJ

    Default 305.1

    Julie is correct, 305.1 is a complete code. While 305.0, 305.2, 305.3, 305.4, 305.5, 305.6, 305.7, 305.8 and 305.9 all require fifth digits, this lonely little code (305.1) does not. It is the only one in this code range that is complete at 4 digits.

    Happy New Year!

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