CODING CORNER: New Lymphoma Codes Add Details -- Is Your Documentation up to Snuff?

Plus say hello to fifth digits for dysphagia, genetic history

Get ready for a slew of new lymphoma codes to master starting Oct. 1. The ICD-9 update will include 54 new lymphoma codes that add greater specifics about type and location.

Tip: Check physician’s documentation for specifics on the type of lymphoma as well as the body part it affects. That information will be essential come October.

The new ICD-9 diagnosis codes include five-digit lymphoma codes for:

• marginal zone lymphoma (200.30-200.38)
• mantle cell lymphoma (200.40-200.48)
• primary central nervous system lymphoma (200.50-200.58)
• anaplastic large-cell lymphoma (200.60-200.68)
• large cell lymphoma (200.70-200.78)
• peripheral T-cell lymphoma (202.70-202.78).
For each of these categories, you can specify whether the lymphoma is in the head, face or neck; the intrathoracic lymph nodes; the intra-abdominal lymph nodes; upper limb; lower limb; intrapelvic; spleen; or multiple sites.

Each type of lymphoma requires a very different treatment, says independent consultant Margaret Hickey, MS, MSN, RN, OCN, CORLN, in New Orleans. So, with these more specific diagnosis codes, you’ll have to be more careful to align each drug with the appropriate diagnosis code.

The Centers for Disease Control & Prevention released the new ICD-9 codes for 2008 with the October deadline and no grace period. The CDC may add more codes to the list between now and October, but most of 2008’s new additions are already available.

Some other ICD-9 changes include:

• You can stop using 787.2 for all dysphagia claims. The 2008 update deletes that code and replaces it with five-digit codes (787.20-787.29). These will let you specify whether the dysphagia is oral, oropharyngeal, pharyngeal or pharyngoesophageal phase.

• Also, V84.8 (Genetic susceptibility to other disease) is going away, replaced with V84.81 (Genetic susceptibility to multiple endocrine neoplasia [MEN]) and V84.89 (... other disease). And there are a half-dozen new “family history” codes, covering malignant neoplasms, cardiovascular diseases and endocrine neoplasia.
• Likewise, say goodbye to myotonic disorders code 359.2, and greet new five-digit myotonic disorder codes 359.21-359.29.

• You’ll have four new codes for female genital carcinoma (233.30-233.39) and multiple endocrine neoplasia (MEN)  (258.01-258.03).

• There are eight new herpes-related diagnosis codes (058.10-058.89). They allow you to specify the type of infection as herpes 6 or 7, plus herpes-related encephalitis.

• The update revises 005.1 (Botulism food poisoning) and adds two new botulism codes: 040.41 (infant) and 040.42 (wound).

• Also, a handful of codes are revised, including 389.14 (Central hearing loss) and 389.18 (Sensorineural hearing loss, bilateral).

- Published on 2007-07-12