Published on
DAVID STERN, MD (Practice Velocity)
Updates to the ICD-9 code set went into effect October 1, 2010. There will be one more regularly scheduled ICD-9 update on October 1, 201, the vastly larger ICD-10 code set is scheduled to take effect.
The following are changes that are of particular interest to us in the urgent care field:
- New code to specify post-traumatic seizures: When a patient experiences seizure(s) as a result of a head injury, physicians now can use a specific code for this condition – ICD-9 code 780.33, Post-traumatic seizures.
- New code for jaw pain: Physicians now have code 784.92 to specify the symptom of jaw pain. (In the past, we had to code jaw pain with the nonspecific code 526.9, Unspecified disease of the jaws, which is still a valid code.)
- New codes related to influenza: To specify pneumonia and other manifestations of avian or novel H1N1 influenza, physicians should use the now-expanded codes 488.01-488.09 and 488.11 – 488.19, as shown in Table 1.
Table 1. New Codes Related to Influenza |
|
| ICD-9 Code | Description of Influenza Condition |
| 488.01 | Influenza due to identified avian influenza virus with pneumonia |
| 488.02 | Influenza due to identified avian influenza virus with other respiratory manifestations |
| 488.09 | Influenza due to identified avian influenza virus with other manifestations |
| 488.11 | Influenza due to identified novel H1N1 influenza virus with pneumonia |
| 488.12 | Influenza due to identified novel H1N1 influenza virus with other respiratory manifestations |
| 488.19 | Influenza due to identified novel H1N1 influenza virus with other manifestations |
- Codes related to retained foreign bodies: Physicians can now indicate the presence of retained foreign bodies with new codes of the V90 series, which classify the retained foreign body by its material composition (Table 2).
When appropriate, two other specific codes should be used in addition to the above codes to indicate the anatomic location of the foreign body:
- 61, Foreign body in anterior chamber
- 6, Residual foreign body in soft tissue
Table 2. New Codes Related to Retained Foreign Bodies |
|
| ICD-9 Code | Composition of Retained Foreign Body |
| V90.01 | Retained depleted uranium fragments |
| V90.09 | Other retained radioactive fragments |
| V90.10 | Retained metal fragments, unspecified |
| V90.11 | Retained magnetic metal fragments |
| V90.12 | Retained nonmagnetic metal fragments |
| V90.2 | Retained plastic fragments |
| V90.31 | Retained plastic fragments |
| V90.32 | Retained tooth |
| V90.33 | Retained wood fragments |
| V90.39 | Other retained organic fragments |
| V90.81 | Retained glass fragments |
| V90.83 | Retained stone or crystalline fragments |
| V90.89 | Other specified retained foreign body |
| V90.9 | Retained foreign body, unspecified material |
- New codes related to intrauterine contraceptive devices (IUDs): use the following new ICD-9 codes for visits related to insertion and removal of IUDs:
- 11, Encounter for insertion of intrauterine contraceptive device
- 12, Encounter for removal of intrauterine contraceptive device
- 13, Encounter for removal and reinsertion of intrauterine contraceptive device
- The code V25.1 for insertion of an intrauterine contraceptive device is now invalid.
- Continue reporting code V25.42 for routine checking of intrauterine contraceptive device.
- New codes for cognitive abnormalities: The new codes detailed in Table 3 allow physicians to better specify types of cognitive deficits.
Table 3. New Codes Related to Cognitive Abnormalities |
|
| ICD-9 Code | Description or Cognitive Abnormalities |
| 799.51 | Attention or concentration deficit |
| 799.52 | Cognitive communication deficit |
| 799.53 | Visuospatial deficit |
| 799.54 | Psychomotor deficit |
| 799.55 | Frontal lobe and executive function deficit |
| 799.59 | Other signs and symptoms involving cognition |
- New codes for lumbar spinal stenosis: Physicians can now use different codes for spinal stenosis to differentiate between patients with and those without neurologic claudication:
- 02 Spinal stenosis, lumbar region, without neurogenic claudication
- 03 Spinal stenosis, lumbar region, with neurogenic claudication
- New code for disorders of defecation: Codes in the 787.6 series have been added to specify disorders of defecation (Table 4). Code 560.39 (Other impaction of intestine) is still valid, but should no longer be used to code for a diagnosis of fecal impaction.
Table 4. New Codes Related to Disorders of Defecation |
|
| ICD-9 Code | Defecation Disorder |
| 787.60 | Full incontinence of feces |
| 787.61 | Incomplete defecation |
| 787.62 | Fecal smearing |
| 787.63 | Fecal urgency |
| 560.32 | Fecal impaction |
- Codes related to Obesity. New V85.4 series (Table 5) codes allow physicians to classify levels of morbid obesity by body mass index.
A related new code (278.03) indicates the diagnosis of obesity hypoventilation syndrome.
Table 5. New Codes Related to Obesity |
|
| ICD-9 Code | Degree of Morbid Obesity |
| V95.41 | Body Mass Index 40.0 – 44.9, adult |
| V85.42 | Body Mass Index 45.0 – 49.9, adult |
| V85.43 | Body Mass Index 50.0 – 59.9, adult |
| V85.44 | Body Mass Index 60.0 – 69.9, adult |
| V85.45 | Body Mass Index 70 and over, adult |
Note: CPT codes, descriptions, and other data only are copyright 2010, American Medical Association. All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the American Medical Association (AMA).
Disclaimer: JUCM and the author provide this information for educational purposes only. The reader should not make any application of this information without consulting with the particular payors in question and/or obtaining appropriate legal advice.
ICD-9 Updates for 2011
