Pediatric Coding Alert

Many new codes abound in final update to proposed ICD-9-CM code set.

If you've felt that your anaphylactic reaction diagnoses could use a bit more specificity, ICD-9 will deliver this October if the proposed list of new, deleted, and revised diagnosis codes becomes final.

The list of ICD-9 changes was recently posted to the CMS Web site, and the proposal constitutes the last full set of changes that the agency will make to ICD-9 codes. After the new codes take effect on Oct. 1, CMS will only add new ICD- 9 codes on an emergency basis as it prepares to switch over the diagnosis coding system to ICD-10, effective Oct. 1, 2013.

Note These Anaphylactic Reaction Code Changes

Pediatric practices typically can't go a week without seeing a patient who suffers from allergic reactions to various substances, and when you reach for an anaphylactic reaction diagnosis code, you may have come up short in the past. But that might be rectified thanks to the latest additions that will take effect in October.

You'll find that the new ICD-9 manual will scrap the previous, non-specific codes 999.4 (Anaphylactic shock due to serum) and 999.5 (Other serum reaction, not elsewhere classified) and replace them with the following new, ultra-specified codes instead:

• 999.41 -- Anaphylactic reaction due to administration of blood and blood products
• 999.42 -- Anaphylactic reaction due to vaccination
• 999.49 -- Anaphylactic reaction due to other serum
• 999.51 -- Other serum reaction due to administration of blood and blood products
• 999.52 -- Other serum reaction due to vaccination
• 999.59 -- Other serum reaction

Pediatricians will also benefit from a new "V" code that will help your anaphylaxis coding with V13.81 (Personal history of anaphylaxis).

Mind This Pilar Cyst Change

In addition, the ICD-9 manual will offer a new code 704.41 (Pilar cyst) to describe pilar cysts, which were previously coded using 706.2 (Sebaceous cyst).

To read the complete list of diagnosis codes for 2012, visit www.cms.gov/AcuteInpatientPPS/IPPS2012 and click on "FY 2012 Proposed Rule Tables."