Neurology & Pain Management Coding Alert

Question: Prior to 2005, ICD-9 listed only a three-digit code (347) to describe narcolepsy. Now, however, ICD-9 lists four separate, five-digit codes for narcolepsy. Can I still report 347 (three digits only) for this condition?


Maine Subscriber

Answer: You should always report diagnoses to the highest level of specificity. This means that if the ICD-9 manual specifies a five-digit code to describe a diagnosis, you can't get away with listing only three or four digits.

Rely on your ICD-9 manual's instructions to ensure you-re listing complete ICD-9 codes. If you see a check mark (4) with a -4th- or -5th- next to a code, ICD-9 is telling you that the code requires a fourth or fifth digit. Anything less would result in an incomplete claim.

As a general rule, you won't usually report a three-digit diagnosis code. Three-digit diagnoses are a red flag for payers, because there are very few ICD-9 codes that don't require at least four digits.

The new codes for narcolepsy in 2005 include:

- 347.00--Narcolepsy; without cataplexy
- 347.01--...with cataplexy
- 347.10--Narcolepsy in conditions classified elsewhere; without cataplexy
- 347.11--...with cataplexy.