Radiology Coding Alert

News alert: The implementation date for the new code set is now official.

Oct. 1, 2014, is your new official goal for your ICD-10 preparation and compliance timeline, according to CMS.

To keep moving steadily toward being ready, continue reviewing the codes your practice is likely to use and take a thorough look at their accompanying guidelines. Case in point: Whether you're using ICD-9 or prepping for ICD-10, picking the proper peritoneal adhesion diagnosis code requires a careful look at the includes and excludes lists. Fortunately, if you master code selection for ICD-9, you'll be ready for ICD-10. Here's why.

Female Pelvis and Gastrointestinal Don't Count

ICD-9's 568.0 (Peritoneal adhesions [postoperative] [postinfection]) finds its counterpart in ICD-10 code K66.0 (Peritoneal adhesions [postprocedural] [postinfection]).

Both code sets agree on the description of the condition as "adhesive bands" or "adhesions (of)" the following sites:

• Abdominal (wall)
• Diaphragm
• Intestine
• Male pelvis
• Mesenteric
• Omentum
• Stomach.

Watch exclusions: ICD-9 and ICD-10 exclude similar conditions and direct the coder to appropriate codes.

For 568.0, the excludes note lists these adhesions:

• Pelvic, female (614.6)
• With obstruction:
• Duodenum (537.3)
• Intestine (560.81).
• For K66.0, you'll find a similar excludes list:
• Female pelvic adhesions [bands] (N73.6)
• Peritoneal adhesions with intestinal obstruction (K56.5).

Look for 'NEC' Code

One difference for reporting pelvic adhesions in ICD-10 as opposed to ICD-9 is the use of a "not elsewhere classified" code, N99.4 (Postprocedural pelvic peritoneal adhesions). The N99 range is defined as "Intraoperative and postprocedural complications and disorders of genitourinary system, not elsewhere classified."

ICD-10 states that N99.4 excludes:

• Pelvic peritoneal adhesions NOS (N73.6)
• Postinfective pelvic peritoneal adhesions (N73.6).

Remember: When ICD-10-CM goes into effect, 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. The announcement about the new implementation date is available before Sept. 5 at https://s3.amazonaws.com/public-inspection.federalregister.gov/2012-21238.pdf. It will be published Sept. 5 at www.federalregister.gov/articles/2012/09/05/2012-21238/adoption-of-a-standard-for-a-unique-health-plan-identifier-addition-to-the-national-provider.