Home Health ICD-9/ICD-10 Alert

5 questions reveal whether you need an ICD-9 brush-up.

Time-saver: This quiz on the new codes and the basics of diagnosis coding will help you determine whether you're on the right track, or if you should work on your 2011 diagnosis coding know-how.

Question 1: How should you report lumbar spinal stenosis with claudication?

A. 729.5 (Pain in limb)

B. 724.03 (Spinal stenosis, lumbar region, with neurogenic claudication)

C. 724.4 (Thoracic or lumbosacral neuritis or radiculitis, unspecified)

D. 782.0 (Disturbance of skin sensation)

Question 2: True or false: You can never report a V code as the primary diagnosis.

Question 3: True or false: You can never report an E code as the primary diagnosis.

Question 4: True or false: A diagnosis of encopresis, NOS, fecal impaction is sufficient documentation for you to list a 787.6x (Incontinence of feces) code.

Answer 1: B. In the past, you may have reported A, C, or D for this diagnosis in addition to 724.02 (Spinal stenosis; lumbar region without neurogenic claudication) for the spinal stenosis, because the ICD-9 manual did not include a specific code for spinal stenosis of the lumbar region with neurogenic claudication. However, you must now report 724.03 for this diagnosis, because it most accurately describes the condition.

Answer 2: False. When a V code is your only option, report it as the primary diagnosis. If you think that you should never report V codes (found near the back of the ICD-9 manual) as primary diagnosis codes, think again.

There was a time many years ago when it was inappropriate to list a V code as the primary diagnosis in home health, but that's no longer the case.

Take note: 2011 saw several new V codes added to your ICD-9 options, but they aren't all appropriate as primary diagnosis codes. Some new V codes include: V88.11 (Acquired total absence of pancreas NOS), V88.12 (Acquired partial absence of pancreas), and V85.41 (Body mass index 40.0-44.9, adult).

Answer 3: True. You should use E codes to describe external causes of injuries or accidents. You should never list E codes as your primary code, and you should always list the E codes last. It may be necessary to assign more than one E code to fully explain each cause.

Answer 4: False. Fecal impaction is now broken into more detail and requires a fifth digit (787.6x) to indicate full incontinence of feces (0), incomplete defecation (1), fecal smearing (2), or fecal urgency (3).