Pediatric Coding Alert

New Sore-Throat Codes Top List of ICD-9 Changes for 2002

New and revised ICD9 Codes for 2002 in several categories, such as sore throats, bronchitis and asthma, tooth disorders, gastrointestinal, skin and neonatal, will be of interest to pediatricians. CMS announced that the new codes may be used on medical claims as early as Oct. 1, 2001, and become mandatory Jan. 2, 2002.
 
The following is a list of new and revised diagnosis codes that will be used commonly in pediatrics. A complete list of changes is available online at www.hcfa.gov/pubforms/transmit/AB0191.pdf.
 
Note: Revised terminology is bold. Eliminated verbiage is struck out.

Sore Throats
 
For obstructed and unobstructed sore throats, there are five new codes:
 
  • 464.00 acute laryngitis without mention of obstruction
     
  • 464.01 ... with obstruction
     
  • 464.5 supraglottitis, unspecified
     
  • 464.50 ... without mention of obstruction
     
  • 464.51 ... with obstruction.

  • Bronchitis and Asthma

    Revised codes:
     
  • 476.1 chronic laryngotracheitis, excludes laryngitis and tracheitis, acute or unspecified (464.00-464.51)
     
  • 478.79 other diseases of larynx, not elsewhere classified, excludes ulcerative laryngitis (464.00-464.01)
     
  • 491.21 obstructive chronic bronchitis with acute exacerbation excludes chronic obstructive asthma with acute exacerbation (493.22)
     
  • 493's fifth-digit subclassification "0" without mention of status asthmaticus or acute exacerbation or unspecified
     
  • 493.2 chronic obstructive asthma excludes acute bronchitis (466.0).

  • Tooth Disorders

    Revised codes:
     
  • 520.0 disorders of tooth development and eruption; anodontia, excludes acquired absence of teeth (525.10-525.19)
     
  • 520.6 disturbances in tooth eruption, excludes exfoliation of teeth (attributable to disease of surrounding tissues) (525.0-525.19)
     
  • 525.1 loss of teeth due to trauma, extraction, or periodontal disease; acquired absence of teeth Revised code title, excludes acquired absence of teeth which is defined by 525.10, and changed "accident" to "trauma."

  • New codes:
     
  • 521.00 dental caries, unspecified
     
  • 521.01 dental caries limited to enamel
     
  • 521.02 dental caries extending into dentine
     
  • 521.03 dental caries extending into pulp
     
  • 521.04 arrested dental caries
     
  • 521.05 odontoclasia; infantile melanodontia; melanodontoclasia; excludes internal and external resorption of teeth (521.4)
     
  • 521.09 other dental caries
     
  • 525.10 acquired absence of teeth, unspecified
     
  • 525.11 loss of teeth due to trauma
     
  • 525.12 loss of teeth due to periodontal disease
     
  • 525.13 loss of teeth due to caries
     
  • 525.19 other loss of teeth.

  • Gastrointestinal

    Revised code:
     
  • 558.9 other and unspecified noninfectious gastroenteritis and colitis; diarrhea, dietetic or noninfectious  Now excludes diarrhea, dietetic or noninfectious.

  • New codes:
     
  • 530.12 acute esophagitis
     
  • 564.00 constipation, unspecified
     
  • 564.01 slow transit constipation
     
  • 564.02 outlet dysfunction constipation
     
  • 564.09 other constipation.

    Skin
  • Revised codes:
     
  • 690 erythematosquamous dermatosis, excludes seborrheic keratosis (702.11-702.19)
     
  • 692.7 contact dermatitis and other eczema; due to solar radiation, excludes sunburn due to other ultraviolet radiation exposure (692.82)
     
  • 692.71 sunburn, first degree sunburn and sunburn NOS
     
  • 692.72 acute dermatitis due to solar radiation, excludes sunburn (692.71, 692.76-692.77)
     
  • 706.3 seborrhea, excludes seborrheic: dermatitis (690.10), keratosis (702.11-702.19).

  • New codes:
     
  • 692.76 sunburn of second degree
     
  • 692.77 ... third degree.

  • Fractures, Dislocations

    Revised codes:
     
  • 733.1 pathologic fracture, excludes stress fracture (733.93-733.95).

  • New codes:
     
  • 733.93 stress fracture of tibia or fibula
     
  • 733.94 ... the metatarsals
     
  • 733.95 ... other bone.

  • Neonatal

    Revised codes:
     
  • 767.0 subdural and cerebral hemorrhage, excludes intraventricular hemorrhage (772.10-772.14).

  • New codes:
     
  • 772.10 intraventricular hemorrhage; unspecified grade
     
  • 772.11 grade I; bleeding into germinal matrix
     
  • 772.12 ... II; bleeding into ventricle
     
  • 772.13 ... III; bleeding with enlargement of ventricle
     
  • 772.14 ... bleeding into cerebral cortex
     
  • 779.7 periventricular leukomalacia.

    Early Development

    Revised codes:
     
  • 783.4 lack of expected normal physiological development in childhood, excludes pituitary dwarfism (253.3)
     
  • 787 symptoms involving digestive system, excludes constipation (564.00-564.09).

  • Open Wounds

    Revised code:
     
  • 870-897 the description "complicated" used in the fourth-digit subdivisions includes those with mention of delayed healing, delayed treatment, foreign body or infection, use additional code to identify infection.

  • V Codes

    Revised code:
     
  • V70.7 examination for normal comparison of participant in clinical trial; examination of participant or control in clinical research Eliminated for normal comparison.

  • New codes:
     
  • V83.0 hemophilia A carrier
     
  • V83.01 asymptomatic hemophilia A carrier
     
  • V83.02 symptomatic hemophilia A carrier.

  • E Codes
     
    Greater specificity of injury helps pediatricians more accurately denote the cause of a condition. Use E codes as a secondary diagnosis with the injury or symptom as the primary diagnosis. E codes of interest to pediatricians include three revised codes and eight new:

    Revised codes:
     
  • E886 fall on same level from collision, pushing, or shoving, by or with other person, excludes crushed or pushed by a crowd or human stampede (E917.1, E917.6)
     
  • E886.0 in sports; tackles in sports, excludes kicked, stepped on, struck by object, in sports (E917.0, E917.5)
     
  • E926.2 exposure to radiation; visible and ultraviolet light sources ... tanning bed.

  • New codes:
     
  • E888.0 fall resulting in striking against sharp object; use additional external cause code to identify object (E920)
     
  • E888.1 ... other object
     
  • E888.8 other fall
     
  • E888.9 unspecified fall; fall NOS
     
  • E917.3 striking against or struck by furniture without subsequent fall, excludes fall from furniture (E884.2, E884.4-E884.5)
     
  • E917.4 other stationary object without subsequent fall
     
  • E917.5 ... object in sports with subsequent fall; knocked down while boxing
     
  • E917.6 caused by a crowd, by collective fear or panic with subsequent fall.