Pulmonology Coding Alert

Before you carry your swine flu diagnosis over to the bird category 488 (Influenza due to identified avian influenza virus), get the facts you need to avoid making an ICD-9 coding error.

Provided you're up to date with the latest ICD-9 coding expert recommendations, your coding for confirmed cases should be on track. "Given the current coding constraints, 487.x (Influenza) is the best choice for the interim period," says Kathy Giannangelo, MA, RHIA, CCS, CPHIMS, FAHIMA, an independent consultant in Springfield, Ill.

Reason: The current code 488 is specific for avian flu. The National Center for Health Statistics (NCHS) has indicated they feel under the current code titles that 487 is the appropriate code, reports Jeffrey F. Linzer Sr., MD, MICP, FAAP, FACEP, associate medical director of compliance and business affairs for the Emergency Pediatric Group at Children's Healthcare of Atlanta at Egleston.

Do this: "Go with the NCHS recommendation and use 487 for now," Linzer advises.

This fall, you'll turn to a new code in an expanded category. In ICD-9 2010, the 488 category covers a broader group of "certain identified influenza viruses," rather than the 2009 limited title "Influenza due to identified avian influenza."

Speed tip: If you look up "swine flu" in the ICD-9- CM 2010 tabular list, the entry will direct you to 488.1 (Influenza due to identified novel H1N1 influenza virus). "It will be appropriate to use the new code starting Oct.1," Linzer says.

"I'm glad to see that the NCHS published a new code after the proposed rule was already out," Giannangelo says. The new code has been created "to provide data capture for the novel H1N1 influenza virus (swine flu virus), which was first identified in April, after the March 2009 ICD-9-CM Coordination and Maintenance Committee meeting," according to the NCHS (www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/ftpicd9.htm).

Don't miss: Two inclusions entries confirm swine flu's migration from 487.x to 488.1. According to ICD-9-CM's Tabular Addenda (www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/icdtab10add.pdf), 488.1's descriptor will include:

• 2009 H1N1 [swine] influenza virus

• novel 2009 influenza H1N1

• novel H1N1 influenza

• novel influenza A/H1N1

• swine flu.