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.