Oncology & Hematology Coding Alert

Start mastering the 2007 codes now

You can stop using -unspecified- diagnosis codes for several chemo-induced syndromes starting Oct. 1.
 
CMS has issued its inpatient prospective payment system (IPPS) rule, including a list of new ICD-9 diagnosis codes that take effect in October 2006. More to come? The list does not include codes approved at the late-March meeting of the ICD-9 Coordination and Maintenance Committee.
 
We-ve rounded up the codes you-re most likely to use:
 
- You won't have to use unspecified code 238.7 (Other lymphatic and hematopoietic tissues) for myelodysplastic syndrome any longer. Next year that condition will have four codes (238.72-238.75), plus codes for thrombocythemia (238.71) and myelofibrosis with myeloid metaplasia (238.76).
 
- Neutropenia was covered under agranulocytosis (288.0), but now it has its own codes (288.00-288.09), including cyclic neutropenia (288.02) and drug-induced neutropenia (288.03). The update also adds 11 other codes for white blood cell count disorders (288.4-288.69).
 
- Next year's ICD-9 codes include a new section (338.x) for different types of pain, including 338.3 (Neoplasm-related pain [acute] [chronic])
 
- Code 528.00 (Stomatitis and mucositis, unspecified) breaks out into four codes, including two for mucositis due to antineoplastic therapy (528.01) and due to other drugs (528.02).
 
- You-ll have new options for reporting test results, including 795.06 (Papanicolaou smear of cervix with cytologic evidence of malignancy), 795.81 (Elevated carcinoembryonic antigen [CEA]), 795.82 (Elevated cancer antigen 125 [CA 125]), and 795.89 (Other abnormal tumor markers).
 
- Once V18.51 (Family history, colonic polyps) becomes effective, you-ll be able to use this more specific code instead of V18.5 (Family history; digestive disorders).
 
Note: CMS posted the proposed IPPS rule on its Web site, including most of the new ICD-9 codes for 2007. You-ll find the rule in the CMS Web site at www.cms.hhs.gov/AcuteInpatientPPS/downloads/cms1488p.pdf, page 840, table 6A.