Primary Care Coding Alert

The headache-free solution to getting your ICD-9 codes up to date. Space crunched on your superbill? These seven steps make fitting the FP must have 2011 codes on your charge sheet a snap. To make your task even easier, the guide takes you section by section through a typical family medicine superbill eliminating any guessing as to where the new entries should go. 1. Add 488.1x to Influenza Superbill Entry You'll sidestep invalid code denials if you add the fifth-digit to your H1N1 claims. Here's how to squeeze in the top new codes you need. On your superbill under Infectious & Parasitic Diseases update 488.1 "Influenza, H1N1" to: 488.12 Influenza, H1N1 w/ URI symptoms Under Respiratory System Lower Respiratory Tract, add: 488.11 Influenza, H1N1 w/ pneumonia. 2. Expand BMI Entries by 5 Don't let your BMI 40 and over ICD-9 codes clog claims payments. After your superbill's Endocrine, Nutritional & Metabolic Disorders Metabolic/Other section, find your V85.4 entry (BMI, 40 and over, adult). Add these entries: V85.41 BMI, 40.0 -44.9, adult V85.42 BMI, 45.0 -49.9, adult V85.43 BMI, 50.0 -59.9, adult V85.44 BMI, 60.0 -69.9, adult V85.45 BMI, 70 and over, adult. 3. Squeeze in Fecal Impaction Specific Code For fecal impaction, you won't be properly coding fecal impaction if you stick with current code 560.39 (Impaction of intenstine; other). Update your superbill to include room for the more specific new code. Under Digestive System after Impaction of Intestine, add: 560.32 Impaction of feces 4. Enter 5^th Digit for 787.6 Listing Subcategory 787.6 (Incontinence of feces) will need a fifth digit starting Oct. 1. Avoid denials by making the following changes to your superbill under Signs & Symptoms. Update 787.6 Encropresis, NOS, fecal impaction to: 787.60 Full incontinence of feces 787.61 Incomplete defecation 787.62 Fecal smearing (soiling) 787.63 Fecal urgency. 5. Solve Jaw Pain Coding With New Symptom Listing Make way for another new Signs & Symptoms code. In that long list of pain entries, add: 784.92 Pain, jaw. 6. Introduce 2 Status Codes to Facility Superbills If your FPs see patients in the inpatient hospital and skilled nursing facility settings, make room for two new V codes. Under the Supplemental Classifications section, include: V49.86 -- DNR status V49.87 -- Physical restraints status. 7. Include New Personal Hx Dysplasia Locations You've got a way to indicate if a female patient has a history of vaginal or vulvar dysplasia. Under the Supplemental Classifications section after the cervical dysplasia entry, add: V13.23  vaginal dysplasia, personal history V13.24  vulvar dysplasia, personal history.