Otolaryngology Coding Alert

Look forward to greater TMJ reporting specificity

Do insurers request further information when you submit 477.8 for a patient who is allergic to cats? You can avoid this extra step, thanks to the new edition of ICD-9. Medicare has done away with the grace period, so you should update your superbills by Oct. 1 if you want to avoid a claim-denial nightmare.

Now ICD-9 contains four "allergic rhinitis" codes but nothing specific to animal-dander-caused rhinitis. If your otolaryngologist diagnoses a patient with allergic rhinitis due to cat or dog hair and dander, you have to submit the other-specified code 477.8 (Allergic rhinitis; due to other allergen). When the new ICD-9 codes become effective on Oct. 1 (check payers'specific implementation dates), you'll be able to assign 477.2 (... due to animal [cat] [dog] hair and dander).

Besides adding 477.2 to your encounter form, make sure to include new temporomandibular joint (TMJ) disorder code 524.64 (Temporomandibular joint sounds on opening and/or closing the jaw). This code will allow you to submit a specific code when your otolaryngologist diagnoses a patient with jaw-clicking TMJ.

Upcoming Otolaryngology Coding Alert issues will keep you abreast of other ICD-9 changes, including expert advice on how to implement the new diagnostic codes.