ICD 10 Coding Alert

'Other specified' and 'unspecified' NHL fall under different codes in ICD-10.

When you start using ICD-10 in 2013, the new code set won't always offer a simple one-to-one relationship to the old codes. Often, you'll have additional options that may require tweaking the way your physician documents a service and the way a coder reports it.

Consider this: Under ICD-9, your go-to code for unspecified or other specified non-Hodgkin lymphoma (NHL) is 202.8x (Other lymphomas). So 202.8x serves as both an NEC (not elsewhere classifiable/other specified) and NOS (not otherwise specified/unspecified) code.

ICD-10 change: ICD-10 does things a little differently by offering one code range for NHL NEC and another code range for NHL NOS.

NEC: ICD-10 2011 includes C85.8- (Other specified types of non-Hodgkin lymphoma) for reporting NHL when the physician documents the type but ICD-10 doesn't offer a more specific code appropriate for that diagnosis. To start preparing to use this code range, take a close look at the ICD-10 codes available for specified types of NHL. That way, you'll be able to identify more quickly when the oncologist documents a type that doesn't match available specific codes. And, just as with ICD-9, be sure to start your ICD- 10 code search in the index for terms that match your documentation. That will help you identify the most specific code for your case.

NOS: ICD-10 2011 includes C85.9- (Non-Hodgkin lymphoma, unspecified) for use when the oncologist documents NHL without stating the specific type.

Fifth digit: The ICD-10 2011 and ICD-9 2011 NHL codes require a fifth digit to be complete. The fifth digit sub-classification is based on the lymph nodes involved. The ICD-10 and ICD-9 options are similar, with one important difference. You will have separate ICD-10 options for unspecified site (0) and extranodal and solid organ sites (9). In ICD-9, the two are both reported using fifth digit 0.