Pathology/Lab Coding Alert

You'll still use location to choose the right code.

When your pathologist diagnoses uterine leiomyomas after Oct. 1, 2013, you'll need to have a new list of codes in your arsenal. That's when the switch from ICD- 9 to ICD-10 will become a reality for your lab.

Background: Fibroids (or myomas) are larger than polyps and are usually imbedded in the smooth muscle of the uterine wall. They are almost always benign, but in rare circumstances, they can become a sarcoma (muscle cancer). They occur in three main locations:

• Submucous fibroids (218.0, Submucous leiomyoma of uterus) grow from the uterine wall toward the uterine cavity. They are also called intracavitary fibroids.
• Intramural fibroids (218.1, Intramural leiomyoma of uterus), also called interstitial fibroids, grow within the uterine wall (myometrium).
• Subserous fibroids (218.2, Subserous leiomyoma of uterus), or subperitoneal fibroids, grow outward from the uterine wall toward the abdominal cavity.

If the physician does not specify the location of the uterine fibroid, assign 218.9 (Leiomyoma of uterus, unspecified) as the diagnosis.

Look ahead: Once payers start requiring ICD-10, your diagnosis codes will include numbers and letters. For example, ICD-10 2010 lists the previously mentioned fibroid codes as:

• D25.0 -- Submucous leiomyoma of uterus
• D25.1 -- Intramural leiomyoma of uterus or Interstitial leiomyoma of uterus
• D25.2 -- Subserosal leiomyoma of uterus or Subperitoneal leiomyoma of uterus
• D25.9 -- Leiomyoma of uterus, unspecified

Head to www.cdc.gov/nchs/icd/icd10cm.htm#10updateto  learn more about ICD-10.