Pulmonology Coding Alert

But first, fifth-digit requirements on NOS go into effect next year.

When a patient experiences accumulation of air or gas in the pleural space, which may occur spontaneously or as a result of trauma or a pathological process, the pulmonologist would likely detect a pneumothorax diagnosis. You would code this with the ICD-9 code 512.x (Pneumothorax).

ICD difference: When ICD-9 transforms to ICD-10 on Oct. 1, 2013, you will modify your pneumothorax coding from 512.x to J93.x (Pneumothorax). Don't forget the four codes under J93.x that describe the condition in greater detail, including:

• J93.0 -- Spontaneous tension pneumothorax
• J93.1 -- Other spontaneous pneumothorax
• J93.8 -- Other pneumothorax
• J93.9 -- Pneumothorax, unspecified.

Pay attention to the type of pneumothorax tidentified in the documentation. Category J93.x excludes some commonly seen forms of pneumothorax: postprocedural (J95.81), traumatic (S27.0), etc.

Coder tips: Coding for pneumothorax gets an overhaul for ICD-9 2012. Often, coders report the code for "not otherwise specified" (NOS) pneumothorax, but for ICD-9 2012, should be seeing a change to how you code.

Under ICD-9 2011, you used 512.8 (Other spontaneous pneumothorax) to report an acute, chronic, or NOS pneumothorax (J93.1 in ICD-10-CM). For ICD-9 2012, you should choose from a range of five-digit 512.8x codes:

• 512.81 -- Primary spontaneous pneumothorax
• 512.82 -- Secondary spontaneous pneumothorax
• 512.83 -- Chronic pneumothorax.

These diagnoses will revert back to other spontaneous pneumothorax (J93.1) when ICD-10 takes effect in 2013.