Cardiology Coding Alert

Plus, check out V13.65 for corrected congenital heart malformations.

Each October you're faced with new ICD-9 codes to add to your diagnosis arsenal. 2011 is no exception, with new ectasia, congenital malformation, and body mass index (BMI) codes you'll need to learn. Take a look at the proposed changes that will affect your cardiology practice, so that you're ready when fall rolls around.

End Your Ectasia Hunt at 447.7x

The proposed changes to ICD-9 2011 add four codes specific to aortic ectasia, which could be among the most significant changes for cardiology coders.

"Ectasia" means dilation or enlargement, and aortic ectasia often refers to an enlargement that is milder than an aneurysm. But ICD-9 2010 does not distinguish ectasia from aneurysm, linking aortic ectasia to 441.9 (Aortic aneurysm of unspecified site without mention of rupture) and 441.5 (Aortic aneurysm of unspecified site, ruptured).

The proposed 2011 codes are specific to aortic ectasia and are based on anatomic site:

• 447.70 -- Aortic ectasia, unspecified site
• 447.71 -- Thoracic aortic ectasia
• 447.72 -- Abdominal aortic ectasia
• 447.73 -- Thoracoabdominal aortic ectasia.

New Corrected Congenital Malformations Code

A number of new codes deal with congenital malformations of the heart and circulatory system. Code V13.65 (Personal history of [corrected] congenital malformations of heart and circulatory system) will be "very useful to our practice," says Janel C. Peterson, CPC, with Alegent Health Clinic Heart and Vascular Specialists in Omaha, Neb. Add BMI V Codes to Your E/M Arsenal

The ICD-9 proposal has "expanded the body mass index (BMI) codes to demonstrate higher BMIs with five new codes," notes Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CENTC, CHCC with CRN Healthcare Solutions in Tinton Falls, N.J.

You'll need to stop using V85.4 (Body Mass Index 40 and over, adult) on Oct. 1 and start using one of the following new V codes in its place:

• V85.41 -- Body Mass Index 40.0 " 44.9, adult
• V85.42 -- Body Mass Index 45.0 " 49.9, adult
• V85.43 -- Body Mass Index 50.0 " 59.9, adult
• V85.44 -- Body Mass Index 60.0 " 69.9, adult
• V85.45 -- Body Mass Index 70 and over, adult.

The benefit: "BMI has become an important health tool, and those codes [V85.41-V85.45] will also provide more data," says Susan Vogelberger, CPC, CPC-H, CPCI, CMBS, CCP-P, CEO of Healthcare Consulting & Coding Education, LLC.

"There are seven vital signs that count for the constitutional bullet in the E/M physical exam coding, and there are those who are of the opinion that BMI should be an eighth option," Vogelberger says. If that eighth bullet gains traction and comes into play for coders, the new V codes could help considerably.