Get on top of upcoming eye infection coding changes
Conjunctivitis is an eye infection that can affect patients of all ages. And most likely your practice is familiar with the signs and symptoms of this condition. However, like all other conditions, conjunctivitis will come under new codes after ICD-10 goes into effect.
Presently, there are several coding options for conjunctivitis, depending on the type of condition that the doctor treats. Under ICD-10, you will not only have to denote the specific type of conjunctivitis by using the most proper diagnosis code, but you'll also have to point out which eye was affected.
Documentation: Already, your doctors should be including the affected eye in their documentation. As a coder, all you need to do to capture this already present information is to format your superbill to capture the additional anatomical information.
Medical coder tips: On your superbill, after ‘conjunctivitis, list the available choices to prompt the doctor to enter this information. A condensed system could include:
Conjunctivitis is an eye infection that can affect patients of all ages. And most likely your practice is familiar with the signs and symptoms of this condition. However, like all other conditions, conjunctivitis will come under new codes after ICD-10 goes into effect.
Presently, there are several coding options for conjunctivitis, depending on the type of condition that the doctor treats. Under ICD-10, you will not only have to denote the specific type of conjunctivitis by using the most proper diagnosis code, but you'll also have to point out which eye was affected.
Documentation: Already, your doctors should be including the affected eye in their documentation. As a coder, all you need to do to capture this already present information is to format your superbill to capture the additional anatomical information.
Medical coder tips: On your superbill, after ‘conjunctivitis, list the available choices to prompt the doctor to enter this information. A condensed system could include:
H10.3x, Unspecified acute conjunctivitis (x=0 for unspecified eye, 1 for right eye, 2 for left eye, and 3 for bilateral)
H10.40x (x=1 for right eye, 2 for left eye, 3 for bilateral, and 9 for unspecified eye)
Key: Remember that the "x" digits in the H10.3x and H10.40x examples above do not translate exactly from one conjunctivitis condition to the other. For H10.3x, a "0" for the final digit refers to an unspecified eye, whereas for H10.40x, a "9" for the final digit refers to an unspecified eye. As such, physician training will be imperative for this condition, and the coder should screen all conjunctivitis diagnoses right away post ICD-10 implementation prior to sending out claims to the insurer.
Strep throat coding changes should be minimal
Probably, primary care practices see patients with symptoms of strep throat every day, and this common illness is marked by pain and redness in the throat, potential fever, and sometimes flushed cheeks (scarlet fever).
While using the ICD-9-CM code set, you use 034.0 (Streptococcal sore throat) if the patient suffers from streptococcal sore throat. The ICD-9 manual also points you to this code if the patient suffers from streptococcal tonsillitis.
ICD-10 changes: With effect from October 1, 2013, you will not have a simple catch-all code for streptococcal throat infections. In its place, ICD-10 codes (Source "http://www.supercoder.com/icd-10/")will differentiate between the following two types of conditions:
Key: Remember that the "x" digits in the H10.3x and H10.40x examples above do not translate exactly from one conjunctivitis condition to the other. For H10.3x, a "0" for the final digit refers to an unspecified eye, whereas for H10.40x, a "9" for the final digit refers to an unspecified eye. As such, physician training will be imperative for this condition, and the coder should screen all conjunctivitis diagnoses right away post ICD-10 implementation prior to sending out claims to the insurer.
Strep throat coding changes should be minimal
Probably, primary care practices see patients with symptoms of strep throat every day, and this common illness is marked by pain and redness in the throat, potential fever, and sometimes flushed cheeks (scarlet fever).
While using the ICD-9-CM code set, you use 034.0 (Streptococcal sore throat) if the patient suffers from streptococcal sore throat. The ICD-9 manual also points you to this code if the patient suffers from streptococcal tonsillitis.
ICD-10 changes: With effect from October 1, 2013, you will not have a simple catch-all code for streptococcal throat infections. In its place, ICD-10 codes (Source "http://www.supercoder.com/icd-10/")will differentiate between the following two types of conditions:
J02.0 (Streptococcal pharyngitis)
J03.00 (Acute streptococcal tonsillitis, unspecified)
J03.01 (Acute recurrent streptococcal tonsillitis)
Documentation: You shouldn't report the strep] throat diagnosis code unless your practice gets confirmation from a lab test (either rapid strep or throat culture) indicating that the patient tested positive for a streptococcal throat infection. If you do not have a positive lab test confirming strep throat, you should just report the diagnosis codes for the symptoms (sore throat, fever, scarlet fever, etc.)
As such, your documentation must include a copy of the laboratory report confirming that the patient had strep throat prior to selecting your diagnosis code.
Key: Your doctor will require to clearly note which type of throat condition the patient has. Contrary to previous years, when one code covered both streptococcal pharyngitis and streptococcal tonsillitis, that will not be the case post ICD-10. As such, it'll be important for your documentation to include a notation of whether the patient's streptococcal infection affected the pharynx or the tonsils.
What's more, if the patient suffers from streptococcal tonsillitis, you'll have to further delineate whether he's experiencing an acute or recurrent condition. If you use J03.01 (recurrent), your documentation will have to confirm that the patient has suffered from the condition in the past.
Medical coder tips: See to it that you print both new strep throat codes on your superbills before ICD-10 goes into effect. You should also let your practitioners know that they'll need to differentiate between streptococcal pharyngitis versus streptococcal tonsillitis.
Documentation: You shouldn't report the strep] throat diagnosis code unless your practice gets confirmation from a lab test (either rapid strep or throat culture) indicating that the patient tested positive for a streptococcal throat infection. If you do not have a positive lab test confirming strep throat, you should just report the diagnosis codes for the symptoms (sore throat, fever, scarlet fever, etc.)
As such, your documentation must include a copy of the laboratory report confirming that the patient had strep throat prior to selecting your diagnosis code.
Key: Your doctor will require to clearly note which type of throat condition the patient has. Contrary to previous years, when one code covered both streptococcal pharyngitis and streptococcal tonsillitis, that will not be the case post ICD-10. As such, it'll be important for your documentation to include a notation of whether the patient's streptococcal infection affected the pharynx or the tonsils.
What's more, if the patient suffers from streptococcal tonsillitis, you'll have to further delineate whether he's experiencing an acute or recurrent condition. If you use J03.01 (recurrent), your documentation will have to confirm that the patient has suffered from the condition in the past.
Medical coder tips: See to it that you print both new strep throat codes on your superbills before ICD-10 goes into effect. You should also let your practitioners know that they'll need to differentiate between streptococcal pharyngitis versus streptococcal tonsillitis.
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