ICD 10 Coding Alert

Celebrate Sinusitis Codes' One-to-One Relationship for ICD-10

Take a look at these common sinusitis diagnoses, and discover what you'll report after October 1, 2013.

Right now: When your physician treats a patient for sinusitis, you should report the appropriate sinusitis code for sinus membrane lining inflammation. Use 461.x for acute sinusitis. For chronic sinusitis -- frequent or persistent infections lasting more than three months -- assign 473.x.

For both acute and chronic conditions, you'll choose the fourth digit code based on where the sinusitis occurs. Forexample, for ethmoidal chronic sinusitis, you should report (473.2, Chronic sinusitis; ethmoidal). Your otolaryngologist will most likely prescribe a decongestant, pain reliever or antibiotics to treat sinusitis.

ICD-10 difference: Good news. These sinusitis options have a one-to-one match with upcoming ICD-10 codes. For acute sinusitis diagnoses, you'll look at the J01.-0 codes. For instance, 461.0 (Acute maximllary sinusitis) translates to J01.00 (Acute maxillary sinusitis, unspecified). Code 461.1 (Acute frontal sinusitis) maps directly to J01.10 (Acute frontal sinusitis). Notice how the definitions are mostly identical. Like ICD-9, the fourth digit changes to specify location.

For chronic sinusitis diagnoses, you'll look to the J32.- codes. For instance, in the example above, 473.2 maps direction to J32.2 (Chronic ethmoidal sinusitis). Again, this is a direct one-to-one ratio with identical definitions. Like ICD-9, the fourth digit changes to specify location.

Physician documentation: Currently, the physician should pinpoint the location of the sinusitis. This won't change in 2013.

Coder tips: You'll scrap the 461.x and 473.x options and turn to J01.-0 and J32.- in your ICD-10 manual. Except for the change in code number and the addition of a letter, you should treat these claims the same as before.