Otolaryngology Coding Alert

You'll need side-specific details to use new hearing loss codes

If you love attention, ICD-9 2008 is for you. With only 146 new codes this fall, ENTs get the lion's share of the focus with more than 20 percent of the diagnoses--30 to be exact--pertaining to them.

The Centers for Disease Control & Prevention has released the new ICD-9 codes for 2008. They take effect Oct. 1, 2007, with no grace period. CDC may add some more codes to the list between now and September, but most of 2008's new additions are already available. Here are the changes you can't afford to overlook. Ask Bilateral or Unilateral Before Using 7 New 389.xx Codes When coding hearing loss using ICD-9 2008 diagnoses, you-re going to have to look for more details in the medical record. The trend toward side-specific loss codes started in 2007 with the additions of ICD-9 codes 389.15 (Sensorineural hearing loss, unilateral) and 389.16 (Sensorineural hearing loss, asymmetrical), says Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CHCC, director of outreach programs for the American Academy of Professional Coders based in Salt Lake City. ICD-9 2008 continues the trend with further granularity. 

The hearing loss category (389) will allow you to differentiate between bilateral and unilateral loss. This added specificity could considerably improve -epidemiology, public policy (e.g., prevalence of hearing loss in children), and hearing loss research efforts,- say Kyle C. Dennis, PhD, CCC-A, FAAA, and Dee Adams Nikjeh, PhD, CCC-SLP, with the American Speech-Language-Hearing Association (ASHA).

Meet new codes 1 and 2: ICD-9 2008 increases the possible conductive hearing loss diagnoses from six to eight codes. The two additional codes include:

- 389.05 for unilateral conductive hearing loss
- 389.06 for bilateral conductive hearing loss. Lowdown on new codes 3 and 4: You-ll gain one ICD-9 code in both the neural and sensory hearing loss families. Codes 389.13 and 389.17 will represent these types unilaterally. Use 389.13 for -Neural hearing loss, unilateral,- and identify -Sensory hearing loss, unilateral- with 389.17.

Get acquainted with new codes 5-7: Three new codes debut in the 389.2 subcategory. These additions will allow you to identify the specific types of losses. You now  have to lump these under one code: 389.2 (Mixed conductive and sensorineural hearing loss).

For unilateral mixed hearing loss, you will assign 389.21, and you-ll report 389.22 for -mixed hearing loss, bilateral.- When the physician needs to order additional testing as a result of the audiogram to further evaluate the hearing loss, you will be able to use the code for unspecified mixed hearing loss (389.20), says Janet Agemian, CPC, administrator at Regional Otolaryngology Associates LLC in Voorhees, N.J.

Benefit: The new terms will allow you to -more accurately and precisely describe the patient's hearing loss,- Agemian [...]