Otolaryngology Coding Alert

Link dermal filler injection service to HIV, facial lipodystrophy codes.

Lipodystrophy in HIV-positive patients is usually the side effect of new drug combination treatments, wherein the patient experiences disturbance of fat metabolism. The signs of lipodystrophy are a swollen belly along with loss of tissue from the face, arms and legs. In ICD-9-CM, lipodystrophy is coded with 272.6. Come 2013, ICD-10-CM will change lipodystrophy's code to E88.1 (Lipodystrophy, not elsewhere classified).

Medicare covers dermal injections for facial lipodystrophy syndrome (G0429, Dermal filler injection[s] for the treatment of facial lipodystrophy syndrome [LDS] [e.g., as a result of highly active antiretroviral therapy]) when diagnosed in HIV-infected patients who also have been diagnosed with depression due to HIV treatment.

ICD difference: The coding rules related to lipodystrophy will be the same in ICD-10-CM as in ICD-9-CM. Medicare will separately pay for the administration and product of dermal filler injections to treat facial lipodystrophy.

Coder tips: Physicians will report dermal filler injection claims for G0429, linking the code to diagnosis codes B20 (Human immunodeficiency virus [HIV] disease) and E88.1. Medicare will not require you to code depression (F32.x) in your claim, but may be required by other payers, so don't forget to check out the policy first.