Internal Medicine Coding Alert

Watch for new code family J32.x with a fourth digit to specify location.

Under the current ICD-9-CM code set, you turn to 473.x (Chronic sinusitis) for patients suffering from chronic infection of sinus if the symptoms persist despite two or more months' treatment.

ICD difference: Effective Oct. 1, 2013, you'll choose from the following ICD-10 codes with the prefix "J" to report chronic sinusitis and its subcategories:

• J32.0 -- Chronic maxillary sinusitis
• J32.1 -- Chronic frontal sinusitis
• J32.2 -- Chronic ethmoidal sinusitis
• J32.3 -- Chronic sphenoidal sinusitis
• J32.4 -- Chronic pansinusitis
• J32.8 -- Other chronic sinusitis
• J32.9 -- Chronic sinusitis, unspecified.

ICD-10 retains the description of chronic sinusitis subcategories from their ICD-9 counterparts. The only addition lies in subcategory J32.4 for chronic pansinusitis, which is currently not available under ICD-9.

Documentation: When the internal physician diagnoses chronic sinusitis, she should note the patient's symptoms of the chronic sinusitis (such as difficulty breathing through the nose, swollen area of the eyes and face, and throbbing facial pain or a headache). Notes regarding rhinosinusitis, hyperplastic sinusitis, chronic rhinosinusitis, and chronic unspecified sinusitis also point to chronic sinusitis. The physician also should pinpoint the location of the sinusitis. For both acute and chronic sinusitis, you should select the fourth digit code based on where the sinusitis occurs.