General Surgery Coding Alert

You-ll continue to rely on 202.8x for unspecified conditions

Upcoming changes for the 2008 ICD-9 manual are now available, and there's one new group of codes you may need when your surgeon performs fine needle aspiration, or excisional, incisional or needle biopsy, for patients with non-Hodgkin's lymphoma.

There are more than 30 subtypes of non-Hodgkin's lymphoma, but all types are now classified to a single nonspecific code (202.8x). ICD-9 2008 will add over 50 codes to allow physicians to more exactly diagnose the conditions. You will find nine of these codes (describing peripheral T cell lymphoma) in category 202 (Other malignant neoplasms of lymphoid and histiocytic tissue), and ICD-9 will classify the others (including marginal zone lymphoma, mantle cell lymphoma and others) to category 200 (Lymphosarcoma and reticulosarcoma, which will include "and other specified malignant tumors of lymphatic tissue" for 2008).

ICD-9 2008 will not include a new code for unspecified non-Hodgkin's lymphoma, and you will continue to report this condition using 202.8x.

Resource: For a complete summary of changes to ICD-9 for 2008, visit the AHIMA Web sit at http://www.ahima.org/dc/documents/MicrosoftWord-CMsummary_0306.pdf.

The long-awaited new diagnosis codes for secondary diabetes will have to wait until the 2009 ICD-9 update.

Secondary diabetes will receive its own category in 2009, said Sheri Bernard during a presentation at the American Academy of Professional Coders 2007 conference in Seattle. Moreover, the subcategories for complications will mirror those for the existing 250.xx series of diabetes codes -- which means coders will have lots of new codes to work with.

These codes should take effect Oct. 1, 2008, if all goes well, says Amy Blum, medical classification specialist with the National Center for Health Statistics, the part of the Centers for Disease Control and Prevention that develops new ICD-9 codes.