We walk you through these can-t-live-without changes Now is definitely the time to prepare for the upcoming tumor and effusion diagnosis code switch that ICD-9 2009 has in store for you. Watch for: These changes include the new 209.xx coding series, which contains over 40 new options for coding carcinoid tumors to the highest possible degree of specificity. Get Ready to Roll This Fall Since HIPAA's passage, there is no grace period for new ICD-9 codes. You have to be ready to hit the ground running for the new codes on Oct. 1, says Joan Gilhooly, CPC, CHCC, president of Medical Business Resources in Chicago. If you send in 2008 codes after your payer updates its code list, you-re sure to see denials. CMS has approved the following codes for use, but slight changes are possible before the list is finalized over the summer. For all the latest news on ICD-9 2009, check out future issues of Oncology & Hematology Coding Alert. Stay on Top of New 209.xx Series You will receive a powerful new tool for increased coding specificity on Oct. 1, when the 209.xx series goes into effect. The M.D. Anderson Cancer Center asked for a new category specifically identifying malignant and benign neuroendocrine tumors, and ICD-9 2009 will include carcinoid tumor code range 209.xx as a result. These new codes cover three general areas primarily involving carcinoid tumors, as well as carcinomas. These codes bring an increased focus on very specific locations for these conditions. These new coding subcategories are as follows: - 209.00-209.29 -- Malignant carcinoid tumors - 209.30 -- Malignant poorly differentiated neuroendocrine carcinoma, any site Note: Code 209.30 is the only new code for neuroendocrine tumors. - 209.40-209.69 -- Benign carcinoid tumor. FYI: A carcinoma is any malignant cancer arising from epithelial cells, while Dorland's Illustrated Medical Dictionary notes that "carcinoid" is used to describe "a yellow circumscribed tumor arising from enterochromaffin cells, usually in the small intestine, appendix, stomach, or colon and less commonly in the bronchus." These new codes offer a more precise option and will provide more accurate statistics than the current 2008 options, 157.4 (Malignant neoplasm of pancreas; Islets of Langerhans) and 259.2 (Other endocrine disorders; carcinoid syndrome), says James C. Yao, MD, associate professor with the University of Texas M.D. Anderson Cancer Center, in his presentation on the new codes, "Neuroendocrine Tumors" at
http://www.cdc.gov/nchs/ppt/icd9/att2_Yao_Sep07.ppt#683, 8 -- Neuroendocrine Tumors: Current Situation (1). Break Bronchus/Lung Tumor Out of Group This Fall Here's an in-depth look at how these codes will work using bronchus and lung examples featuring 2009 codes 209.21 (Malignant carcinoid tumor of the bronchus and lung) and 209.61 (Benign carcinoid tumor of the bronchus and lung). You currently report 162.9 (Malignant neoplasm [...]
