Internal Medicine Coding Alert

Question: An established patient presented to the internist complaining of pain during urination. The internist ordered a non-automated dip stick urinalysis (the practice owns the urinalysis equipment). Notes indicate that post-urinalysis, the internist diagnosed the patient with "micro hematuria." Is there an ICD-9 code for "micro hematuria?"

Nebraska Subscriber

Answer: The condition your physician describes is microscopic hematuria, which means that the blood in the patient's urine was not plainly visible. There is no specific code for this condition -- yet.

If you are filing this claim for a September date of service, you should report 81000 (Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy) with 599.7 (Hematuria) appended to represent the patient's condition.

Coding changes imminent: Beginning with services provided on or after Oct. 1, you'll be expected to use the ICD-9 2009 codes, which don't include 599.7. The new code set for hematuria in ICD-9 2009 consists of:

• 599.70 -- Hematuria, unspecified

• 599.71 -- Gross hematuria

• 599.72 -- Microscopic hematuria.

New way: If you are coding for an encounter that occurred on or after Oct. 1., report 81000 with 599.72 appended to represent the patient's condition.

Remember: There is no longer a grace period for new ICD-9 codes, so 599.7 won't fly for dates of service after Sept. 30. For more info on ICD-9 2009 and how it will affect your coding, check out Vol. 11, No. 7 of Internal Medicine Coding Alert.