Proposed changes to ICD-9-CM for 2009 call for the greatest number of revisions in more than a decade. CMS unveiled, in an April 15 announcement, more than 330 new diagnosis codes. A few significant additions include codes to identify carcinoid tumors by site, a dedicated category for secondary diabetes mellitus (249), and codes classifying pressure ulcers by stage. In addition to the 330 proposed diagnosis codes, CMS received requests that another set of more than 120 diagnosis codes be "fast tracked" for inclusion in 2009. The ultimate decision on how many new codes will appear in the 2009 ICD-9 manual will come when the Final Rule is published in the Federal Register in August. All approved 2009 ICD-9 codes will become effective Oct. 1. General Surgery Coding Alert will bring you additional information as it becomes available. For those readers wanting to view the 32-page list of the proposed ICD-9 codes for 2009, contact John Verhovshek at codewrite@comcast.net