Urology Coding Alert

Don’t expect a straight 1-to-1 transition.

Urologists often perform circumcisions to treat phimosis and balanitis, and payers will reimburse for these procedures with the correct diagnostic codes. When your urologist performs a circumcision for either of these conditions, your diagnosis coding is fairly easy. 

But when ICD-10 goes into effect in October 2015, you’ll need more details to choose the proper diagnosis code. Read on to get the scoop. 

Terminology: Phimosis is a condition of the penis in which the prepuce can’t be drawn back to uncover the glans penis. Balanitis, also known as balanoposthitis, is commonly described as an infection of the foreskin. 

Get Specific Next Year

Under ICD-9, you’ll report 605 (Redundant prepuce and phimosis) when your urologist documents that the patient has phimosis. If he instead performs a circumcision for balanitis, you’ll report 607.1 (Disorders of penis: Balanoposthitis, balanitis).

ICD-10: Next fall, if the urologist documents that the patient has phimosis, you’ll need to look for more details. That is because you’ll choose from one of the following codes: 

• N47.0 — Disorders of prepuce; Adherent prepuce, newborn
  
• N47.1— ... Phimosis
  
• N47.2 — ...  Paraphimosis
  
• N47.3 — ... Deficient foreskin
  
• N47.4 — ... Benign cyst of prepuce
  
• N47.5 — ... Adhesions of prepuce and glans penis
  
• N47.7 — ... Other inflammatory diseases of prepuce
  
• N47.8 — ... Other disorders of prepuce.
  

For patients with balanitis or balanoposthitis, you will choose between N47.6 (Balanoposthitis) and N48.1 (Balanitis).

Physician documentation: Your urologist should already be documenting the specifics of the type of problem the patient has, and for the most accurate ICD-10 coding you should encourage your urologist to continue being specific on every operative report.

Superbill updates: Keep in mind that because 605 and 607.1 do not have one-to-one code crosswalks, you probably will need to make additional room on your superbill for these ICD-10 diagnostic codes.

News: Physician groups have sent requests to Congress to delay the implementation of ICD-10 until 2017. To see what these groups are asking Congress, visit journal.ahima.org and search on ICD-10. If you do not wish to face another delay, contact your public officials and ask them to support the Oct. 1, 2015 compliance date and to vote “no” on any additional delays. You can contact your legislators using American Health Information Management Association’s (AHIMA) advocacy tools by visiting capwiz.com/ahima/home.