Urology Coding Alert

Urologists can now code prostate problems with greater specificity because of new ICD-9 codes that went into effect as of October 2001. Prostate dysplasia codes are increasingly important as physicians seek to identify signs of cancer early and to differentiate the early signs from actual carcinoma. There are also new codes for retrograde ejaculation and hesmatospermia.
 
These common problems required their own diagnosis codes. There is also a new note explanation what a "complicated'' wound is. For example, a post-surgical wound that has major infection or delayed healing takes a fourth digit. If the cause was infection, the physician must specify the type of infection. 
  
Prostate disorders: Code 602.3 (dysplasia of prostate)  includes prostatic intraepithelial neoplasm I (PIN I) and prostatic intraepithelial neoplasm II (PIN II). It excludes prostatic intraepithelial neoplasm III (PIN III), which is coded 233.4 (carcinoma in situ; prostate).
 
Male genital organs: Code 608.82 is for hematospermia and 608.87 for retrograde ejaculation.
 
Note: Code 608.8 (other specified disorders of male genital organs) now requires a fifth digit.
 
A note has been added to 870-897: The description "complicated" used in the fourth-digit subdivisions includes those with mention of delayed healing, delayed treatment, foreign body or infection. Also added: Use additional code to identify infection. Urologists would be most likely to use 876.x (open wound of back), 878.x (open wound of genital organs [external], including traumatic amputation) and selected codes in the 879.x series (open wound of other and unspecified sites, except limbs).
 
Personal history: There is a new code for personal history of malignant neoplasm; renal pelvis (V10.53). Renal pelvis is now deleted from V10.52 ( kidney). This is a category change, but the specificity of diagnosis has not been changed.