Otolaryngology Coding Alert

Don't code -runny nose- every time you see one

Although new entries for -runny nose- and -scratchy throat- might make you think you-ve hit the jackpot, you should reserve these diagnoses for specific cases. Get the lowdown on when to use these signs and symptoms codes, as well as a sneak peak at what changes ICD-9 has in store.

Rethink Your Allergy Symptom Coding
 
ICD-9 2008 may make it easier for you to thumb to the correct code for two respiratory symptoms. You may have additional index entries for:

- runny nose (784.99, Other symptoms involving head and neck)
- scratchy throat (784.99).

Reserve reporting these codes for instances in which the allergist makes no definitive diagnosis. Use signs and symptoms when the physician didn't know at the time of work the patient's specific condition, says Vicky V. O-Neil, CPC, CSS-P, president of The Hazlett Group in St. Louis.

Example: A patient complains of a runny nose with clear discharge for several weeks, no fever. The allergist does not make a diagnosis of allergies. In this case, you should report the sign and symptom, runny nose (784.99), available for claims dated Oct. 1 and later.

Caution: Never let your fingers do the walking in the Alphabetic Index alone. -Verify the code number in the Tabular List, Volume 1,- O-Neil says. You could miss valuable coding instructions if you skip this step.

Anticipate Changes to 8 Areas

The Centers for Disease Control & Prevention released the new ICD-9 codes for 2008. They take effect Oct. 1, with no grace period. Some more codes may be added to the list between now and September, but most of 2008's new additions are already available. Some other ICD-9 changes include:

- You-ll have 54 new lymphoma codes (200.30-202.78) that specify the type of lymphoma and the body part it affects.

- Stop using 787.2 for all dysphagia claims. The 2008 update deletes that code and replaces it with five-digit codes (787.20-787.29) that let you specify the dysphagia's phase as unspecified, oral, oropharyngeal, pharyngeal, pharyngoesophageal or other.

- Also, V84.8 (Genetic susceptibility to other disease) is going away, replaced with V84.81 (Genetic susceptibility to multiple endocrine neoplasia [MEN]) and V84.89 (... other disease). And there are half a dozen new -family history- codes, covering malignant neoplasms, cardiovascular diseases and endocrine neoplasia.

- Likewise, say goodbye to myotonic disorders code 359.2, and greet new five-digit myotonic disorder codes 359.21-359.29.

- You-ll have four new codes for female genital carcinoma (233.30-233.39) and multiple endocrine neoplasia (men) (258.01-258.03).

- There are eight new herpes-related diagnosis codes (058.10-058.89). They allow you to specify types of infection between herpes 6 or 7, plus herpes-related encephalitis.

- The new update revises 005.1 (Botulism food poisoning) and adds two new botulism codes: 040.41 (infant) and 040.42 (wound).

- Also, a handful of codes are revised, including 389.14 (Central hearing loss) and 389.18 (Sensorineural hearing loss, bilateral).