Cardiology Coding Alert

Don't skip the fine print with new diagnosis codes The new edition of ICD-9 just made coding for elevated CRP a little easier. Although ICD-9 didn't introduce hundreds of new cardiology diagnosis codes, you should know which new codes will affect your practice as of Oct 1. The Centers for Disease Control and Prevention and CMS unveiled their new ICD9 codes , and because payers do not allow a grace period for the new codes, you should update your superbills by Sept. 30. Code 790.95 for Elevated CRP Testing levels of C-reactive protein (CRP), one of the blood's acute phase proteins that increase during systemic inflammation, may be a new way to assess cardiovascular disease risk. Instead of coding elevated CRPas 790.99 (Other nonspecific findings on examination of blood; other), you can now use 790.95 (Elevated C-reactive protein [CRP]), says Anne Karl, RHIA, CCS-P, CPC, coding and compliance specialist for St. Paul Heart Clinic in Mendota Heights, Minn.

Tracking use of the new aspirin code (V58.66, Long-term [current] use of aspirin) could reveal the population use of aspirin to establish payer incentives, Karl says. The new code further expands a relatively new group of diagnosis codes specific to patients who take long-term antithrombotic and anti-inflammatory medications (V58.63, Long-term [current] use of antiplatelet/ antithrombotics) such as Plavix, those taking nonsteroidal anti-inflammatory drugs (V58.64, Long term [current] use of nonsteroidal anti-inflammatories [NSAID]), and those patients taking steroid medications (V58.65, Long-term [current] use of steroids).

Note: For more information on these diagnoses, refer to the August 2003 Cardiology Coding Alert. ICD-9 Expands V Code Listing New codes that affect cardiology: V46.11 -- Dependence on respirator, status
V49.83 -- Awaiting organ transplant status
V58.44 -- Aftercare following organ transplant
V58.66 -- Long-term (current) use of aspirin
V58.67 -- Long-term (current) use of insulin
V69.4 -- Lack of adequate sleep
453.40 --Venous embolism and thrombosis of unspecified deep vessels of lower extremity
453.41 -- Venous embolism and thrombosis of deep vessels of proximal lower extremity
453.42 -- Venous embolism and thrombosis of deep vessels of distal lower extremity
790.95 -- Elevated C-reactive protein (CRP). Note: ICD-9's updated diabetes code series (250.00-250.93) no longer reflects insulin versus non-insulin dependency. Physicians should now dictate either type I, type II, unspecified, or juvenile diabetes instead of pass terminologies NIDDM and IDDM. To review a full listing of the new ICD-9 codes, visit the CMS Web site at http://www.cms.hhs.gov/medlearn/icd9code.asp#coding.