Urology Coding Alert

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.

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 impaired renal function. These changes are in conjunction with changes to the non-renal hyperparathy-roidism codes in section 252.x.

The addition of ICD code V84.03 (Genetic susceptibility to malignant neoplasm of prostate) will allow for better statistical tracking of genetic predispositions to prostate cancer, already known to be hereditary. "As the human genome is unraveled, more and more 'markers' are being found," Hause says, "and this is a welcome proactive addition to allow for tracking predispositions for patients."

Warning: CMS has scrapped the 90-day grace period to begin using new ICD-9 codes. You will have to begin using new and revised ICD-9 codes when CMS introduces them on Oct. 1, 2004. For more information, see "Say Goodbye to Your Coding Compliance Grace Periods" in the May 2004 Urology Coding Alert.

For a complete list of new and invalid ICD-9 codes, visit www.cms.hhs.gov/medlearn/icd9code.asp.