OASIS Alert

Diagnosis Coding:

GEAR UP FOR A SLEW OF NEW ICD-9 CODES IN OCTOBER

New diagnosis codes could provide additional case mix codes.

If you've felt like your infection coding could use a tune-up, new ICD-9 codes deliver, with 12 new codes targeting infections.

And that's just the tip of the iceberg, with 141 new codes you'll be able to use as of Oct. 1.

The new codes address a variety of diseases needing more specific descriptions, which could increase your coding accuracy. Check out these new codes that could be useful to home health agencies:

Oncology: Cancer diagnosis codes get one of the biggest expansions. The following codes are indicative of what you'll see effective Oct. 1:

209.31-209.36 --Merkel cell carcinoma

209.70-209.74 --Secondary neuroendocrine tumor

285.3 -- Antineoplastic chemotherapy induced anemia.

Last year's ICD-9 update brought a large number of new neuroendocrine codes. About half of those identify malignant tumors, and were added to the casemix codes in malignancy, points out Judy Adams, president and CEO of Adams Home Care Consulting in Chapel Hill, N.C.

The addition of 285.3 harkens back to another area that saw expansion last year -- blood and blood disorders. This is another likely case mix code, Adams says.

Late effects: Look for two new codes to report late effects of cerebrovascular disease.

438.13 -- Late effects of cerebrovascular disease, dysarthria

438.14 -- Late effects of cerebrovascular disease, fluency disorder.

All of the 438.x codes are currently Neuro 3 case mix codes, Adams says.

GI diagnoses: There are three new gastrointestinal codes that look like they could become case mix codes, Adams says.

569.71 -- Pouchitis

569.79 -- Other complications of intestinal pouch

569.87 -- Vomiting of fecal matter.

Fractures: Look for two new fracture codes that could potentially be added to the Ortho 2 category, Adams says.

813.46 -- Torus fracture of the ulna (alone)

813.47 --Torus fracture of radius and ulna.

Myopathies: Two other new codes could possibly be added to the Ortho 2 case mix category as well, Adams says.

359.71 -- Inclusion body myositis

359.79--Other inflammatory and immune myopathies, NEC.

Brain conditions: There are two codes for conditions of the brain that could possibly be included in the Neuro 1, brain case mix category, Adams says.

348.81 -- Temporal sclerosis

348.89 --Other conditions of the brain.

Look Beyond Potential Case Mix Codes

There are several new codes that agencies may find useful in describing patient conditions, Adams says. These include:

Venous codes: Watch for scores of new codes to report venous embolism and thrombosis, such as:

453.50-453.79 --Chronic venous embolism and thrombosis

453.81-453.89 -- Acute venous embolism and thrombosis.

Speech disturbances: Speech-language pathologists will welcome five new codes including:

784.42 -- Dysphonia

784.43 -- Hypernasality

784.44 -- Hyponasality

784.51 -- Dysarthria

784.59 -- Other speech disturbance.

Poisoning: You'll find a dozen new poisoning codes among the slew of ICD-9 codes, such as:

969.00 -- Poisoning by antidepressant,unspecified

969.01 -- Poisoning by monoamineoxidase inhibitors

969.71 -- Poisoning by caffeine

969.72--Poisoning by amphetamines.

V codes: Proposed new V codes include several new "personal history" codes:

V10.90 -- Personal history of unspecified type of malignant neoplasm

V10.91 -- Personal history of malignant neuroendocrine tumor

V15.52 -- Personal history of traumatic brain injury

V87.43--Personal history of estrogen therapy

V87.44 -- Personal history of inhaled steroid therapy

V87.45--Personal history of systemic steroid therapy

V87.46-Personal history of immunosuppressive therapy.

Note: For training on the latest new, revised and deleted ICD-9 codes, especially changes you're most likely to see in home care, register for Eli's Aug. 19 audioconference at www.audioeducator.com/industry_conference.php?id=1528 or call 1-800-508-2582.

To read the complete list of new, revised,and deleted ICD-9 codes that will take effect on Oct. 1, visit www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/icdidx10add.pdf.