Pathology/Lab Coding Alert

Some conditions change classification.

Ready or not, here it comes. More changes came down the pike for ICD-10, just over a year before you'll need to implement the new code set in your lab.

CMS recently posted the 2012 ICD-10 code update, which not only shows which codes were added, deleted, and revised this year, but also offers information on the new diagnosis coding system, which will be mandatory for all providers as of Oct. 1, 2013.

Shift Code Family for Some

In 2011, ICD-10 codes for hemorrhoids were found in the I84 category (Diseases of veins, lymphatic vessels, and lymph nodes, not elsewhere classified), which spanned from I84.0 (Thrombosed hemorrhoids) through I84.6 (Residual hemorrhoidal skin tags). Now, however, hemorrhoids are classified with "Diseases of the digestive system" (K00-K945), which is found in chapter 11 of ICD-10.

You'll find the ICD-10 codes for hemorrhoids now assigned to codes K64.0 (First degree hemorrhoids) through K64.9 (Unspecified hemorrhoids). Many other ICD-10 codes follow suit with new and revised code assignments.

Do this: To prepare for ICD-10, you should make a list of the top 30 most common codes that you see in your lab -- or more if you find that number too limiting. Now's the time to make -- or update -- that list so you'll have the most current information as the ICD-10 transition approaches.

Watch duplicates: CMS also released a list of duplicate codes that show which ICD-10 descriptors are assigned to the exact same codes as an existing ICD-9 classification. For instance, if you look up the ICD-10 code for "Wilson's disease" and find that it's E83.01, you'll note that in ICD-9, E83.01 is currently an active diagnosis code to represent a boat accident (which will eventually be coded using V90.89 under ICD-10). It is unclear whether CMS intends on replacing the ICD-10 codes that are repeated (with different meanings) under ICD-9, or whether they have simply pointed out the duplicates to make practices aware of the differences.

For more on the 2012 ICD-10 changes, visit www.cms.gov/ICD10/11b14_2012_ICD10CM_and_GEMs.asp.