Oncology & Hematology Coding Alert

Plus: Check out the latest update on the new code set's implementation date.
 
Mark Oct. 1, 2014, on your calendars. That's the new official compliance date for ICD-10-CM and ICD-10-PCS, according to a CMS final rule published in the Federal Register. Keep your preparations going full speed ahead with these tips for proper coding of prostate specific antigen (PSA) test results.
 
ICD-9-CM: Current ICD-9-CM reporting options for a PSA test include V76.44 (Special screening for malignant neoplasms; prostate) and 790.93 (Elevated prostate specific antigen [PSA]).
 
ICD-10-CM difference: When ICD-10-CM replaces ICD-9-CM, you'll still have one screening diagnosis code and one elevated PSA diagnosis code.
 
When the physician orders a screening PSA test for a patient with no signs or symptoms of disease, screening code V76.44 is the appropriate code under ICD-9-CM. With ICD-10-CM, you'll report Z12.5 (Special screening for malignant neoplasms; prostate).
 
For a diagnostic PSA test when the lab result shows an elevated PSA, you should report 790.93 as the ICD-9-CM diagnosis. When ICD-10-CM comes around, you'll use R97.2 (Elevated prostate specific antigen [PSA]).
 
Physician documentation: Under ICD-9-CM, the physician should pinpoint whether the PSA test is a screening or diagnostic test, and unlike some other scenarios for the ICD-9 to ICD-10 transition, this won't change in 2014.
 
Coder tips: Understanding the meaning of "screening" is important to accurate coding. A note with Z12 (Encounter for screening for malignant neoplasms) states that "Screening is the testing for disease or disease precursors in asymptomatic individuals so that early detection and treatment can be provided for those who test positive for the disease." Consequently, the Z12 range excludes encounters for diagnostic exams, which are performed because the patient presented with signs or symptoms.
 
Remember: When ICD-10-CM goes into effect, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update. The announcement about the new implementation date was available before Sept. 5 at https://s3.amazonaws.com/public-inspection.federalregister.gov/2012-21238.pdf. It was published Sept. 5 at www.federalregister.gov/articles/2012/09/05/2012-21238/adoption-of-a-standard-for-a-unique-health-plan-identifier-addition-to-the-national-provider.