Urology Coding Alert

Report specific genital prolapses and track prostate cancer susceptibility with these new 2005 codes CMS released the 2005 ICD-9 Changes -- effective Oct. 1 -- and these new codes will have a significant impact on urologists, especially urogynecologists and urologists who perform prolapse repairs. New Codes Ease Coding of Genital Repairs By far the biggest changes -- especially for urogynecologists and urologists who sub-specialize in female genital/urological disorders -- are within the genital prolapse section, 618.x. Previously, ICD-9 code 618.0 was essentially a not-elsewhere-classified code for cystoceles, urethroceles and perineoceles, says Roseanne Ramirez, medical biller for the Center for Female Continence in Salinas, Calif. Starting in October, there will be fifth digits added to the section to allow for separate identification of the different types of vaginal wall prolapse. The new genital prolapse codes, effective Oct. 1, are: 618.00 -- Unspecified prolapse of vaginal walls
618.01 -- Cystocele, midline
618.02 -- Cystocele, lateral
618.03 -- Urethrocele
618.04 -- Rectocele
618.05 -- Perineocele
618.09 -- Other prolapse of vaginal walls without mention of uterine prolapse
618.81 -- Incompetence or weakening of pubocervical tissue|
618.82 -- Incompetence or weakening of rectovaginal tissue
618.83 -- Pelvic muscle wasting
618.89 -- Other specified genital prolapse. The above codes will help with the coding of repairs done for these conditions by allowing separate identification of the disorder for each corresponding CPT code when urogynecologists perform vaginal repairs (57200-57289), says Morgan Hause, CCS, CCS-P, privacy and compliance officer for Urology of Indiana LLC, a 22-urologist practice in Indianapolis. "The addition of 618.81 to 618.89 allows for better classification of less common prolapses," he adds, "which would previously fall into the NEC code 618.8." When these new codes are introduced in October, two old codes from the 618 series -- 618.0 (Prolapse of vaginal walls without mention of uterine prolapse) and 618.8 (Other specified genital prolapse) -- will be rendered invalid. Report 618.09 instead of 618.0, and 618.89 instead of 618.8. Impaired Renal Function Codes Elaborated On Two codes have been added to -- and one code deleted from -- the 588 series (Disorders resulting from impaired renal function). Previously, you would have had to use 588.8 (Other specified disorders resulting from impaired renal function) to report secondary hyperparathy-roidism of renal origin. In October, 588.81 (Secondary hyperparathyroidism [of renal origin]) will be a separate classification within the 588 section specifically for this condition. "588.81 is primarily going to be a code used by nephrologists," Hause says, "but it can impact urology due to the cause-and-effect relationship with renal pathology." Code 588.8 will be invalid in October. Instead, use the new code 588.89 (Other specified disorders resulting from impaired renal function) as the "not elsewhere classified" code for [...]