Home Health & Hospice Week

Master these coding changes by Oct. 1.

It's less than a few short months until you must be ready to report the new and changed 2011 ICD-9 codes. Now that the Centers for Medicare & Medicaid Services has finalized the update that will take effect Oct. 1, you can get a jump start on the changes.

The 2011 ICD-9 update expands the body mass index (BMI) codes to demonstrate higher BMIs with five new codes. In the past, you had just one V code to represent a BMI index over 40 (V85.4), but the new edition of ICD-9 will provide additional sub-classifications, ranging from a BMI of 40.0 to 44.9 (V85.41) through a BMI of 70 and over (V85.45).

While official coding guidelines state that BMI can be coded based on clinical assessment, obesity must be documented by the physician before you can list a code for it, says coding expert and attorney Lisa Selman-Holman of Selman-Holman & Associates and CoDR -- Coding Done Right in Denton, Texas.

On the bench: Although CMS had hinted that new codes and modifications to better describe congestive heart failure, multiple sclerosis, complications of cystostomies and aspiration pneumonia resulting from a procedure (see Eli's HCW, Vol. XIX, No. 22, p. 170), these changes didn't make the 2011 ICD-9 update.