Factor in New 2006 ICD-9 Codes in 5 Areas or Face Denials
Published on Tue Jun 21, 2005
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From a QT syndrome code to new sleep apnea codes, you've got five areas of new ICD-9 changes to contend with beginning Oct. 1. Don't let your claim denials pile up due to expired diagnosis codes - stay on top of your coding with this expert rundown of the codes you need to implement this fall. 1. Mind Your Q's and T's - Long QT Syndrome, That Is If your electrophysiology patient has long QT syndrome, no longer will you need to report 794.31 (Abnormal electrocardiogram [ECG] [EKG]).
Instead, you will get more exact with this new EP-specific code and report 426.82 (Long QT syndrome) as of Oct. 1. That's big news, because some practices "like ours, have quite a few patients with long QT syndrome," says B. J. Stepps, office manager at Heart Rhythm Associates in Greenville, N.C.
Remember, the QT interval is an indirect measure of the duration of the ventricular action potential (depolarization) and ventricular refractory period (repolarization). The length of the QT interval depends on the patient's heart rate. Therefore, the QT interval is usually corrected for the heart rate and denoted as "QTc." 2. Expand Kidney Failure Code Reporting Come this fall, ICD-9 2006 will add seven new fourth digits to code 585 (Chronic renal failure) to describe the different stages of renal disease:
585.1 - Chronic kidney disease, stage I
585.2 - ... stage II (mild)
585.3 - ... stage III (moderate)
585.4 - ... stage IV (severe)
585.5 - ... stage V
585.6 - End-stage renal disease
585.9 - Chronic kidney disease, unspecified. ICD-9 code 585 will be an "invalid" code, meaning you will not be able to report it as a three-digit diagnosis and are required to add the fourth digit.
"The renal failure codes add a much needed change to reflect the specificity now made by nephrologists with regard to how far along a patient is toward total failure," says Morgan Hause, CCS, CCS-P, privacy and compliance officer for Urology of Indiana LLC in Indianapolis.
Warning: Clinicians will debate whether to use the stage-V or end-stage renal disease code. The best advice is to look to your physician's documentation, which will have to increase in specificity to accommodate for these codes. 3. Notice This Minute Hypertension Revision If you're reporting hypertension, you're likely using codes such as 404.01 (Hypertensive heart and renal disease, malignant, with heart failure). ICD-9 has revised these code descriptors in such a minute way that you've got to be on your toes.
For example, after Oct. 1, 404.01's descriptor will be "Hypertensive heart and kidney disease, malignant, with heart failure."
"Renal disease" no longer appears in the descriptors of codes [...]
