ICD-9 Coding Tips for Your Pediatric Practice

The ICD-9 2012 code changes have just gone into effect on October 1, which means you'll soon need to be well-versed with the latest changes. This time there are not much diagnosis code changes as far as your pediatric practice is concerned. But there are still quite a few that could lead you to denied claims if you're not aware about it.

Here are some pediatric coding scenarios to help your ICD-9 coding:

For instance when a 12-year-old patient presents with influenza due to identified novel influenza A virus with pneumonia you should go for new code 488.81. Prior to this, you'd most likely have used 487.0; however that code did not specify the nature of influenza A.

The ICD-9 Committee has revised the influenza codes several years, which might make coding these conditions confusing; however the most important fact to remember when reporting these illnesses is to check the documentation for confirmation of the type of influenza that the patient suffers from. When you're in doubt, you should check any lab reports or ask the physician to clarify.

What's more, you'll find revised diagnosis code descriptors for the H1N1 codes for these codes: 488.11, 488.12, and 488.19.

And what if a patient comes for a tuberculosis skin test and the results come back showing that the patient experienced a reaction to the test but doesn't have active tuberculosis. Well, from October 1, the ICD-9 code listing has deleted code 795.5 and replaced it with a couple of more specific codes, one of which is the right answer to this question, 795.51.

ICD-9 has also come up with code 795.52 to separate out the former 795.5 category.

And what if a six year old patient presents with a rare anaphylactic reaction owing to a vaccination that your pediatrician administered earlier in the day? Well, in 2012, you'll have a wide range of anaphylactic reaction codes, including 999.42 which describes this situation more specifically than other codes.

Now you will not be able to report previous codes 999.4 and 999.5 as these codes have been axed. Many other anaphylaxis codes have been revised too.

And in a situation where a ten year old patient presents with a migraine headache with aura, but without status migrainosus, you should go for 346.01 now post ICD-9 2012 code changes.