Medicare Compliance & Reimbursement

If you've got high hopes that you'll have a lot of new ICD-9 codes to use starting this fall, CMS may deliver, with a proposal to debut over 300 new diagnosis codes.

CMS will publish the full listing of ICD-9 codes in the April 30 Federal Register, but released the changes that the agency proposes in the 2009 Inpatient Prospective Payment Systems document (available at http://www.cms.hhs.gov/AcuteInpatientPPS/downloads/CMS-1390-P.pdf).

Leukemia: You'll find dozens of new leukemia codes on the list, which expand diagnosis coding options for this disease. For instance, new code 207.02 (Acute erythremia and erythroleukemia, in relapse) is more specific than the 2007 code 207.0x (Acute arythremia and erythroleukemia).

Oncology: The 2009 ICD-9 manual could feature an entirely new section, if the proposed codes are made final this August.

The new oncology code section is in the 209.00 to 209.69 range, with 43 new codes that represent both malignant and benign carcinoid tumors of various sites.

Diabetes: CMS also proposes introducing 20 new codes to represent secondary diabetes conditions (249.00-249.91). "We're seeing more and more secondary diabetes cases, so these codes will be useful," says Randall Karpf with East Billing.

Headaches: You'll find an expanded section in the proposed ICD-9 codes that represent headache and migraine codes such as 346.43 (Menstrual migraine, with intractable migraine, so stated, with status migrainosus) and 339.85 (Primary stabbing headache).

Pap tests: You'll also find an expanded section for Papanicolaou smear tests in the 795.x and 896.x range. New codes in this category include 795.13 (Papanicolaou smear of vagina with low grade squamous intraepithelial lesion [LGSIL]), and 795.15 (Vaginal high risk human papillomavirus [HPV] DNA test positive), among others.

"These will be helpful with the new focus on HPV diagnosis and prevention that we're seeing practices focus on," Karpf says.

Most of the deletions are diagnoses that will be replaced by more specific codes. For instance, V15.5 (Personal history of injury) will be deleted, but new code V15.59 (Personal history of other injury) will take its place.