General Surgery Coding Alert

V codes provide greater specificity for family and personal history of disease

The May 4 Federal Register included a complete list of more than 140 new ICD-9 codes for 2006, along with over a dozen code deletions and 25 code revisions. As in past years, the trend is toward greater diagnosis specificity.

Example: Now, you can simply report a diagnosis of dehydration, but starting in October, surgeons will have to distinguish between unspecified volume depletion (276.50), dehydration (276.51) and hypovolemia (276.52).

Adding specificity to diagnosis coding "is very much a conscious effort," says Amy Blum with the National Center for Health Statistics at the Centers for Disease Control and Prevention, which designs the ICD-9 codes.

More changes: Instead of just stating chronic renal failure or end-stage renal disease, new codes 585.1-585.5 will require physicians diagnosing chronic kidney disease to specify where it falls in stages I through V.

History Codes Could Support Testing

The 2006 update includes a set of V codes (V12.42-V13.03 and V17.81-V18.9) for a personal or family history of diseases such as pneumonia or osteoporosis. As with most V codes, you probably won't use these history codes as a primary diagnosis, but they could provide valuable secondary or signs-and-symptoms information, especially for diagnostic testing meant to establish a definitive diagnosis.

"We haven't had a lot of great ways to describe this in the past, and the new V codes are going to be a great help," says Marcella Bucknam, CPC, CCS, CPC-H, CCS-P, HIM program coordinator at Clarkson College in Omaha, Neb.

Learn more: You can find a complete list of the new, deleted and revised ICD-9 codes in tables 6A, 6C and 6E of the May 4 Federal Register, available online at www.access.gpo.gov/su_doctors/fedreg/a050504c.html. Scroll down to "Centers for Medicare & Medicaid Services" and "Proposed Rules" to find the link.