Home Health ICD-9/ICD-10 Alert

Avoid coding the deleted dialysis code.

ICD-9 2009 brings 300 new or revised codes. Which changes will most affect home health coders? Trish Twombly, RN, BSN, HCS-D, CHCE, director of coding with Foundation Management Services in Denton, Texas shares her "Top 10" list of codes that will impact home health.

• 707.20-707.25 (Pressure ulcer stages) (See story on page 81.)

• New combination codes for Staph aureus -- 041.11 (Methicillin susceptible Staphylococcus aureus) and 041.12 (Methicillin resistant Staphylo-coccus aureus). (Watch for a story on these codes in the next issue of Home Health ICD-9 Alert.)

• New neoplasm codes in new category 209 (Neuroendocrine tumors) (Garner case mix points for the malignant versions under PPS.)

• New fifth digit "2" to indicate "in relapse" for leukemia codes in categories 203.xx-208.xx.

• New category 249.xx (Secondary diabetes mellitus) to indicate diabetes that is the result of another specific disease process, or that develops when pancreatic tissue which is responsible for producing insulin is absent because it is destroyed by disease. (See story on page 83.)

• New complication code 998.33 (Disruption of traumatic injury wound repair).

• New history V codes V13.51 (Personal history of pathologic fracture) and V13.52 (Personal history of stress fracture).

• V code V46.3 (Wheelchair dependence).

• Revised code V45.11 (Renal dialysis status). Previously, you could report that a patient was receiving renal dialysis with V45.1 (Renal dialysis status), but now this code requires five digits.

Caution: Sending claims with the old code could lead to denials.