Practice Management Alert

You have no time to waste in preparing your practice for the 2004-2005 ICD-9 changes. In February, the Centers for Medicare & Medicaid Services scrapped the 90-day grace period you once had to implement new ICD-9 codes, meaning you should be ready to use the new codes on Oct. 1. Some highlights from the new and revised codes:

Diabetes: Starting Oct. 1, the diabetes code (250.xx) fifth-digit descriptors will no longer contain the phrases "insulin dependent" and "non-insulin dependent." Instead, physicians should determine how well a patient's pancreatic beta cells function to distinguish between type I and type II diabetes and assign the appropriate fifth digit, says Beth Fisher, medical systems specialist with the National Center for Health Statistics in Hyattsville, Md.

Also, the fifth-digit descriptors will no longer include the "adult-onset type" designation for type II diabetes. Patients of all ages can develop type II diabetes, and the term "adult-onset" was confusing when coders tried to assign the right code.

Decubitus ulcers: Now, the only code for a decubitus ulcer is the "very nonspecific" 707.0 (Decubitus ulcer), says JenniferAndres,health information and compliance coordinator for St. Luke's Home Health Servicesin Duluth, Minn. Starting in October, the code choices for decubitus ulcers will include fifth digits to identify the location of the ulcer. The increased specificity should provide greater coding clarity.