Pathology/Lab Coding Alert

Lose ICD-9 2009 H1N1 reference.

Influenza reporting gets more specific once you quit using ICD9, so let us help you learn how 487-488 expand to three code families under ICD-10.

Remember: CMS has announced a proposed implementation date change from Oct. 1, 2013 to Oct. 1, 2014 for the new diagnosis code set.

'Influenza' Equals 'Unidentified'

If you're reporting an influenza diagnosis when the lab test results don't pinpoint a specific virus, expect to use 487 (Influenza) under ICD-9. Fourth digits allow you to express manifestations, as follows:

• 487.0 -- ... with pneumonia
• 487.1 -- ... with other respiratory manifestations
• 487.8 -- ... with other manifestations.

For ICD-10, you'll expand these three codes to eight codes that specify "unidentified influenza" and provide greater manifestation granularity:

• J11.00 -- Influenza due to unidentified influenza virus with unspecified type of pneumonia
• J11.08 -- ...with specified pneumonia
• J11.1 -- ... with other respiratory manifestations
• J11.2 -- ... with gastrointestinal manifestations
• J11.81 -- ... with encephalopathy
• J11.82 -- ... with myocarditis
• J11.83 -- ... with otitis media
• J11.89 -- ... with other manifestations.

Distinguish 'Novel' for ICD-10

ICD-9 provides the following three codes for certain identified influenza, each requiring a fourth digit for "pneumonia," "other respiratory," and "other" manifestations:

• 488.0 -- Influenza due to identified avian influenza virus
• 488.1 -- ... identified 2009 H1N1 influenza virus
• 488.8 -- ... novel influenza A.

In contrast, ICD-10 includes avian influenza, swine influenza, influenza of other animal origin, and influenza A/H5N1 under J09.x (Influenza due to identified novel influenza A virus). You'll also need a fourth digit for "pneumonia," "other respiratory," "gastrointestinal," and "other" manifestations.

ICD-10 also distinguishes J10 (Influenza due to other identified influenza virus) with third and fourth digits as follows:

• J10.00 -- ... with unspecified type of pneumonia
• J10.01 -- ... with the same other identified influenza virus pneumonia
• J10.08 -- ... with other specified pneumonia
• J10.1 -- ... with other respiratory manifestations
• J10.2 -- ... with gastrointestinal manifestations
• J10.81 -- ... with encephalopathy
• J10.82 -- ...with myocarditis
• J10.83 -- ... with otitis media
• J10.89 -- ... with other manifestations.