Radiology Coding Alert

Just like ICD-9, ICD-10 instructions will help you match documentation and code terminology.

Your radiologist may use ultrasound or MRI to evaluate uterine fibroids or may perform uterine fibroid embolization. After Oct. 1, 2013, you'll need to have a new list of diagnosis codes in your arsenal to represent these benign tumors. That's when the switch from ICD- 9 to ICD-10 will be official.

Background: Fibroids (or myomas) are larger than polyps and are usually embedded in the smooth muscle of the uterine wall. They almost always are benign, but in rare circumstances they can become a sarcoma (muscle cancer). Uterine fibroids occur in three main locations:

• Submucous fibroids (218.0, Submucous leiomyoma of uterus) grow from the uterine wall toward the uterine cavity. They are also called intracavitary fibroids.
• Intramural fibroids (218.1, Intramural leiomyoma of uterus), also called interstitial fibroids, grow within the uterine wall (myometrium).
• Subserous fibroids (218.2, Subserous leiomyoma of uterus), or subperitoneal fibroids, grow outward from the uterine wall toward the abdominal cavity.
• If the physician does not specify the location of the uterine fibroid, assign 218.9 (Leiomyoma of uterus, unspecified) as the diagnosis.

Look ahead: Once you start using ICD-10, your diagnosis codes will include numbers and letters. For example, ICD-10 2010 lists the previously mentioned fibroid diagnoses as:

• D25.0, Submucous leiomyoma of uterus
• D25.1, Intramural leiomyoma of uterus Interstitial leiomyoma of uterus
• D25.2, Subserosal leiomyoma of uterus Subperitoneal leiomyoma of uterus
• D25.9, Leiomyoma of uterus, unspecified.

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.