Radiology Coding Alert
738.4 Has Multiple ICD-10 Equivalents to Prepare For
Distinguish these 2 diagnoses
ICD-10 implementation in 2013 is coming fast, so take steps now to prepare. Each month, Radiology Coding Alert highlights a diagnosis code relevant to radiology and shows how the ICD-9 diagnosis compares to its ICD-10 counterpart(s).
Diagnosis in focus: Acquired spondylolisthesis is one condition you'll have many more coding options for with ICD-10 than you do under ICD-9.
Current code: ICD-9 offers you 738.4 (Acquired spondylolisthesis). The ICD-9 index points you to this code for acquired, degenerative, and traumatic spondylolisthesis, as well as for acquired spondylolysis.
Spondylolisthesis is the forward movement of one lower lumbar vertebral body on the vertebra below it (or on the sacrum). Spondylolysis involves degeneration of a portion of the vertebra. Spondylolysis (degeneration) can lead to spondylolisthesis (vertebra shifting out of place).
ICD-10 changes: M43.0- offers options for various types of spondylolysis, and code family M43.1- addresses various spondylolisthesis diagnoses. ICD-10 further divides your options based on spinal region.
The fourth digit "0" or "1" differentiates between the two conditions (0, spondylolysis; and 1, spondylolisthesis). The fifth digit differentiates the anatomic spinal region or location:
Excludes1: Both code families have Excludes1 notes you should check. In particular, notes with each code family exclude Q76.2 (Congenital spondylolisthesis), which is appropriate for both congenital spondylolysis and congenital spondylolisthesis
"An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition," ICD-10 guidelines explain.
Remember: When ICD-10 goes into effect on Oct. 1, 2013, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.
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