Otolaryngology Coding Alert

Code J32.x with a fourth digit to specify location.

When using the ICD-9-CM code set, you would report 473.x (Chronic sinusitis) for patients suffering from chronic infection of sinus if the symptoms persist despite two or more months' treatment. This condition interferes with drainage and causes mucus to build up, and is also known as rhinosinusitis, hyperplastic sinusitis, chronic rhinosinusitis, and chronic unspecified sinusitis.

ICD difference: Effective Oct. 1, 2013, you will use the following ICD10 codes with the prefix J to report chronic sinusitis and its subcategories:

ICD-10 retains the description of chronic sinusitis subcategories from their ICD-9 counterparts, with the addition of one subcategory J32.4 which describes chronic pansinusitis which is currently not available to us under ICD9.

Documentation: The otolaryngologist should note the symptoms of the chronic sinusitis, which may include difficulty breathing through the nose, swollen area of the eyes and face, and throbbing facial pain or a headache. Don't code the condition unless your otolaryngologist specifies it on his notes, and she should pinpoint the location of the sinusitis. For both acute and chronic sinusitis, you should select the fourth digit code based on where the sinusitis occurs.

Coder tips: You will have to turn to J32.x in your ICD-10 manual. However, no significant change in treatment of these claims will happen; these codes' functions will remain the same as before.