Pathology/Lab Coding Alert

Prepare to change Dx coding for CF screening.

If you’re reporting the screening diagnosis — or the results — when your lab runs molecular tests for cystic fibrosis (CF) such as 81220 (CFTR [cystic fibrosis transmembrane conductance regulator] [e.g., cystic fibrosis] gene analysis; common variants [e.g., ACMG/ACOG guidelines]), you have some changes coming.

When ICD-10 goes into effect Oct. 1, 2014, you’ll no longer use the following codes:

• V77.6 — Screening for cystic fibrosis
• V83.81 — Cystic fibrosis gene carrier

Instead, you should report the screening order and the carrier status as follows:

• Z13.228 — Encounter for screening for other metabolic disorders
• Z14.1 — Cystic fibrosis carrier

Change Focus for CF manifestations

ICD-9 uses the fifth digit to define symptoms associated with a patient’s CF diagnosis, as follows: 

• 277.00 — Cystic fibrosis without meconium ileus 
• 277.01 — … with meconium ileus 
• 277.02 — … with pulmonary manifestations 
• 277.03 — … with gastrointestinal manifestations 
• 277.09 — … with other manifestations

But ICD-10 changes the hierarchy, categorizing CF based on pulmonary, intestinal, or other manifestations, as follows

• E84.0 — Cystic fibrosis with pulmonary manifestations
• E84.1 — Cystic fibrosis with intestinal manifestations
  
  • E84.11 — Meconium ileus in cystic fibrosis
  • E84.19 — Cystic fibrosis with other intestinal manifestations
• E84.8 — Cystic fibrosis with other manifestations
• E84.9 — Cystic fibrosis, unspecified

Remember: You must report the fifth digit for E84.1