Home Health ICD-9/ICD-10 Alert

Looking for new case mix codes? They could be just around the corner.

If you've felt like your infection coding could use a tune-up, the new batch of ICD-9 codes delivers, with 12 new codes that target infections.

And that's just the tip of the iceberg, with 141 new codes you'll be able to use as of Oct. 1. Read on for a few highlights.

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.

Last year's ICD-9 update brought a large number of new neuroendocrine codes. About half of those identify malignant tumors, which were added to the case mix codes in malignancy, points out Judy Adams, RN, BSN, HCS-D, COS-C, president and CEO of Adams Home Care Consulting in Chapel Hill, N.C. The addition of 285.3 harkens back to another area that saw expansion last year -- blood and blood disorders. This is another likely case mix code, Adams says.

Late effects: Look for two new codes to report late effects of cerebrovascular disease.

• 438.13 -- Late effects of cerebrovascular disease, dysarthria

• 438.14 -- Late effects of cerebrovascular disease, fluency disorder.

All of the 438.x codes are currently Neuro 3 case mix codes, Adams says.

GI diagnoses: There are three new GI codes that look like they could become case mix codes, Adams says.

• 569.71 -- Pouchitis

• 569.79 -- Other complications of intestinal pouch

• 569.87 -- Vomiting of fecal matter.

Fractures: Look for two new fracture codes that could potentially be added to the Ortho 2 category, Adams says.

• 813.46 -- Torus fracture of the ulna (alone)

• 813.47 -- Torus fracture of radius and ulna.

Myopathies: Two other new codes could possibly be added to the Ortho 2 case mix category as well, Adams says.

• 359.71 -- Inclusion body myositis

• 359.79 -- Other inflammatory and immune myopathies, NEC.

Brain conditions: There are two conditions of the brain codes that could possibly be included in the Neuro 1, brain case mix category, Adams says.

• 348.81 -- Temporal sclerosis

• 348.89 -- Other conditions of the brain.

Beyond the possible additional case mix codes, there are several new codes that home health may find useful in describing patient situations, Adams says. These include:

Venous codes: Watch for scores of new codes to report venous embolism and thrombosis, such as:

• 453.50-453.79 -- Chronic venous embolism and thrombosis

• 453.81-453.89 -- Acute venous embolism and thrombosis.

Speech disturbances: Speech-language pathologists will welcome five new codes including

• 784.42 -- Dysphonia

• 784.43 -- Hypernasality

• 784.44 -- Hyponasality

• 784.51 -- Dysarthria

• 784.59 -- Other speech disturbance.

Poisoning: You'll find a dozen new poisoning codes among the slew of ICD-9 codes, such as:

• 969.00 -- Poisoning by antidepressant, unspecified

• 969.01 -- Poisoning by monoamine oxidase inhibitors

• 969.71 -- Poisoning by caffeine

• 969.72 -- Poisoning by amphetamines.

V codes: Proposed new V codes include several new "personal history" codes:

• V10.90 -- Personal history of unspecified type of malignant neoplasm

• V10.91 -- Personal history of malignant neuroendocrine tumo,

• V15.52 -- Personal history of traumatic brain injury

• V87.43 -- Personal history of estrogen therapy

• V87.44 -- Personal history of inhaled steroid therapy

• V87.45 -- Personal history of systemic steroid therapy

• V87.46 -- Personal history of immunosuppressive therapy.

To read the complete list of new, revised, and deleted ICD-9 codes that will take effect on Oct. 1, visit www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/icdidx10add.pdf.