Pediatric Coding Alert

Check out how your autism coding options will change under ICD-10.

If you've become accustomed to marking the "other specified pervasive developmental disorder" code 299.8x for Asperger's patients, you'll have to adjust your thinking once the ICD-10 diagnosis coding system kicks in. That's because you'll be lucky enough to have a specific code for this disorder, which pediatricians see fairly often.

Although children with autism may see a wide variety of specialists during the course of their treatment, it's often the pediatrician who initially diagnoses the patient with the condition, and who treats the patient on an ongoing basis.

The following autism codes currently exist under ICD-9:

• 299.0x - Autistic disorder
• 299.1x - Childhood disintegrative disorder
• 299.8x - Other specified pervasive developmental disorders. The parenthetical notes for this code indicate that it includes Asperger's disorder
• 299.9x - Unspecified pervasive developmental disorder

The "x" place holders in the ICD-9 codes are currently replaced with a "0" (Current or active state) or a "1" (Residual state), which must be indicated on claims with any of these diagnoses.

ICD-10 difference: After Oct. 1, 2013, you'll no longer need a fifth digit designation to indicate whether the patient's condition is active or residual. In addition, your coding options will be expanded, with the significant addition of F84.5 to give Asperger's syndrome its own code. The ICD-10 codes for pervasive development disorders, including those on the autism spectrum, include the following:

• F84.0 - Autistic disorder
• F84.2 -Rett's syndrome
• F84.3 -Other childhood disintegrative disorder
• F84.5 -Asperger's syndrome
• F84.8 -Other pervasive developmental disorders
• F84.9 -Pervasive developmental disorder, unspecified. The parenthetical note for this code indicates that it includes "atypical autism."

Documentation: Unlike in the past, your documentation will clearly have to include the diagnosis of Asperger's syndrome if the patient has that condition, since you'll be reporting a specific code for it (F84.5) with ICD-10, versus the "other" diagnosis code of 299.8x that you currently report under ICD-9.

Coder Tips: Check the listing of new ICD-10 codes and prepare your superbills ahead of time. When ICD-10 takes effect, you'll want to make sure you list the new autism code (F84.0) as well as any other commonly-diagnosed syndromes that your practice sees. For instance, if you treat a lot of Asperger's patients, you'll list F84.5 on the superbill as well. In addition, educate your physicians about the change to let them know how their documentation should be more specific going forward.