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Diagnosis Coding:

GET READY FOR 141 NEW ICD-9 CODES EFFECTIVE OCT. 1

Published on Wed Apr 22, 2009

Some of the new codes may help you with ICD-10.

With ICD-10 looming around the corner, don't forget that you still have to keep up with ICD-9 updates, too.

The Centers for Medicare & Medicaid Services has issued 141 new diagnosis codes for you to use starting Oct. 1.Most of the new codes will offer additional specificity to existing diseases, which can help you code more accurately. "Any time we get diagnosis codes that provide additional specificity, I think that is great," says Marvel J. Hammer of MJH Consulting in Denver.

You'll find new codes in most categories, ranging from oncology (such as the 209.31-209.36 series, Merkel cell carcinoma) to orthopedics (813.46-813.47, Torus fracture).

You'll also find an expansion of the 799.2 (Nervousness) section, with new codes for irritability (799.22), impulsiveness (799.23), and demoralization and apathy (799.25), among others.

"The new fifth digit ICD-9 codes can be used to report emotional and/or behavioral symptoms," Hammer says. "If these symptoms are associated as a late effect to a traumatic brain injury (TBI), the new ICD-9 code(s) could be paired with the appropriate late effect code, 905.0 (Late effect of fracture of skull and face bones) or 907.0 (Late effect of intracranial injury ...)."

Coding late effects generally requires two codes, Hammer says. The condition or nature of the late effect is sequenced first; the late effect code is sequenced second. But if the emotional/behavioral signs and symptoms are inherent in an established diagnosis, you should not code them separately.

"Additionally, these new codes parallel the ICD-10-CM codes found in the R45.X Symptoms and Signs Involving Emotional State section, allowing for easier mapping when providers convert to ICD-10 in 2013," Hammer says.

Here are a few more new code highlights:

Gastro: The new edition of ICD-9 codes will expand several coding options, including:

• 756.73 -- Gastroschisis

• 569.71 -- Pouchitis

• 569.79 -- Other complications of intestinal pouch

• 569.87 -- Vomiting of fecal matter

• 789.7 - Colic.

Oncology: One of the biggest ICD-9 expansions in the new set of codes deals with cancer diagnoses,with the following codes indicative of what you'll see effective Oct. 1:

• 209.31-209.36 -- Merkel cell carcinoma

• 209.70-209.74 -- Secondary neuroendocrine tumor

• 285.3 --Antineoplastic chemotherapy induced anemia

Venous codes: Scores of new codes are added for vein coding, such as the following:

• 453.50-453.79 -- Chronic venous embolism and thrombosis

• 453.81-453.89 --Acute venous embolism and thrombosis

Note: To read the complete list of new, revised, and deleted ICD-9 codes that will take effect on Oct. 1, go online to www.federalregister.gov/OFRUpload/OFRData/2009-10458_PI.pdf and scroll to page 956.

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