Medicare Compliance & Reimbursement
Show Septis, Then Bill For Septic Shock
Clarifications, not new codes, highlight ICD-9 changes. Find A Primary Diagnosis To Accompany Sepsis If the doctor removes organs prophylactically because of a genetic predisposition to cancer, use a code from subcategory V50.4x (Prophylactic organ removal) as the principal or first code, followed by the genetic predisposition code and the family history code.
If you're a physician treating a patient with septic shock, make sure the condition is a secondary diagnosis on the encounter form.
Why? The Centers for Medicare and Medicaid Services has released a clarification on rules regarding diagnosis coding for patients with septic shock. The clarification explains that a physician's office should never report any codes from ICD-9 subcategory 995.9 (Sepsis) as the principal diagnosis. Instead, the physician must assign the underlying systemic infection code first.
That's just one of the changes in the April 1 revision to the ICD-9 guidelines. CMS didn't issue any new ICD-9 codes for April, but it did shake up the rules a little. To wit, CMS says physicians can't bill for septic shock unless they've documented sepsis, and an external cause-of-injury code is not needed with sepsis codes.
The update also clarifies coding for Type I and Type II diabetes, insulin pump malfunction, postoperative cerebrovascular accident, chronic obstructive pulmonary disease and genetic carrier or susceptibility status.
Medicare Compliance & Reimbursement
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Show Septis, Then Bill For Septic Shock
Clarifications, not new codes, highlight ICD-9 changes.
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