Pulmonology Coding Alert

Good news: Pulmonology won’t face many diagnosis code changes

Every year, you’re faced with changes to the ICD-9 and CPT codes you use to report your pulmonologist’s services. This year, the Oct. 1 diagnosis changes will give you a few new codes to incorporate, but you’ll be spared a major overhaul.
 
The 2006 ICD-9 update offers 478.11 (Nasal mucositis [ulcerative]), allowing you to provide further specificity of the patient’s condition rather than using the more general code 478.1 (Other diseases of nasal cavity and sinuses), says Susan Vogelberger, CPC, CPC-H, CMBS, owner and president of Healthcare Consulting & Coding Education LLC in Boardman, Ohio.
 
ICD-9 2007 also separates out acute bronchospasm and identifies it as a separate and distinct condition, using new code 519.11 (Acute bronchospasm), says Carol Pohlig, BSN, RN, CPC, ASC, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia. Now you’re forced to identify acute bronchospasm as a general acute component of another condition (for example, acute exacerbation of bronchiolitis, emphysema, bronchitis, COPD, etc.) or lump it into the general category (“other diseases of trachea and bronchus”) if no other disease process is present.
 
Another new code your practice may find useful is 784.91 (Postnasal drip). “We see a lot of patients with postnasal drip, so that code could get reasonably frequent use,” says Alan L. Plummer, MD, professor of medicine, Division of Pulmonary, Allergy, and Critical Care at Emory University School of Medicine in Atlanta. Plummer also says that you’ll be able to use new postoperative pain codes (338.12 and 338.22) for postoperative thoracotomy patients who present to your physician with pain following surgery.
 
Review the chart, at right, to see which other ICD-9 codes will affect your pulmonology coding this fall.