Otolaryngology Coding Alert

ICD-10:

Your 'Mono' Code Will Have More than One Option in 2014

Published on Thu Nov 29, 2012

Don't forget to make this fifth digit selection.

When ICD-10 goes into effect, you'll need more information to accurately report a patient's mono. Here's what you need:

Background: Mononucleosis (or mono) is an infection caused by the Epstein-Barr virus. The virus is found in saliva and mucus and is passed through kissing or exposure to a cough, sneeze or sharing food utensils (such as drinking glasses, spoons and forks) with someone who has mono. Symptoms (including fever, sore throat, fatigue, weakness, and swollen glands in the neck or armpits) in young children are generally mild, while symptoms in adolescents and young adults tend to be more severe. The illness is most common in patients ages 15-35.

ICD-9-CM Code

Currently, you should report mono with 075 (Infectious mononucleosis). That's your only choice.

ICD-10-CM Codes

After ICD-10 goes into effect, you'll have more options. They are:

B27.0, Gammaherpesviral mononucleosis
B27.1, Cytomegaloviral mononucleosis
B27.8, Other infectious mononucleosis
B27.9, Infectious mononucleosis, unspecified

Don't forget to add these fifth-digit classifications for each code category:

0, without complication

1, with polyneuropathy

2, with meningitis

9, with other complications

ICD-10 differentiates between several types of the disease and further distinguishes between infection with or without complication and whether the patient also has polyneuropathy or meningitis.

Documentation: The physician might make an initial diagnosis of mononucleosis based on the symptoms listed above. Blood tests can confirm mono and rule out other possible causes of the symptoms, such as strep throat. Early blood tests might show an increase in one type of white blood cells that might have an atypical appearance. More specific blood tests can confirm the diagnosis of mono.

Only report a diagnosis of mono once blood tests have confirmed the patient's illness.

Once ICD-10 goes into effect, physicians will need to be more detailed in their documentation of infectious mononucleosis. They'll need to specify the exact type and also note complications and/or associated diseases polyneuropathy (a condition that involved damage to multiple nerves) and/or meningitis (Inflammation of the membranes surrounding the brain and spinal cord).

Coder Tips: On your superbill, after infectious mononucleosis, list the available options to prompt the physician to enter the necessary information. Abbreviated options could include:

XXXXX, GHV mono

XXXXX, CMV mono

XXXXX, Other infect mono

XXXXX, Infect mono unspecified

Also prompt the physician to mark the appropriate fifth-digit classification:

0, w/out complication

1, w/ polyneuropathy

2, w/ meningitis

9, w/ other complication.