Neurology & Pain Management Coding Alert

Coming soon: Changes to seizure codes -- and everything else.

If you think keeping up with the new 2009 ICD-9 codes is tough, just wait. In three years, you might have more than 155,000 new codes to deal with.

What happened: On Aug. 15, the Department of Health and Human Services (HHS) announced a proposal to replace the ICD-9 codes with the ICD-10 series effective Oct. 1, 2011. Not only will this new code set require an overhaul of your claims systems, software, and superbills, it may require retraining for your entire staff.

A recent CMS MLN Matters article (SE0832) states, -Compared to the current ICD-9 classification system, ICD-10 offers more detailed information and the ability to expand specificity and clinical information in order to capture advancements in clinical medicine. Providers may want to become familiar with the new coding system.-

The ICD-9 code series you-re familiar with includes about 17,000 codes. The ICD-10 code set contains more than 155,000 codes, including the Volume 3 Procedure Coding System (PCS) codes. That's a lot to wrap your mind around. -We-ve been thinking of ICD-10 as this far-away prospect that may never take hold,- says Heather Corcoran with CGH Billing. -The new announcement sort of brings us back to the reality that this will indeed take effect.-

For example: In the United States, you might choose one of the 345.xx (Epilepsy and recurrent seizures) ICD-9 codes, such as 345.40 (Localization-related [focal] [partial] epilepsy and epileptic syndromes with complex partial seizures, without mention of intractable epilepsy) for a patient presenting with epilepsy or seizures.

Elsewhere in the world, however, coders might choose between the following:

- G40.009 -- Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, without status epilepticus
- G40.319 -- Generalized idiopathic epilepsy and epileptic syndromes, intractable, without status epilepticus
- G40.519 -- Special epileptic syndromes, intractable, without status epilepticus.

These examples are among several other options. These are the codes used by most industrialized countries around the world already, as classified by the World Health Organization.

According to CMS, ICD-10 incorporates greater specificity and clinical information to the codes. It is hoped these changes will result in an improved ability to measure healthcare services and enhance CMS's ability to conduct public health surveillance.

Bonus for coders: Another of ICD-10's goals is to decrease your need to include supporting documentation with claims, which should make both you and your neurologist happy. ICD-10 also includes updated medical terminology and classification of diseases -- among many other changes.

Head start: To read more about the ICD-10 changes, visit the CMS Web site at www.cms.hhs.gov/ICD10.