Cardiology coder may often be bowled over by questions such as this, while glancing through the ICD-9 manual.
ICD 9 codes online, ICD-9 manual, Medical Coding
If you are a cardiology coder, you may often be bowled over by questions such as this. “While glancing through the ICD-9 manual, I wanted to have a look at the ICD-9 codes for sarcoidosis with cardiomyopathy. In the index, under ‘sarcoidosis, cardiac’, the listing is 135, with 425.8 italicized. When I looked up 425.8 in the tabular list, I saw that code and definition were in italics. So what do the brackets and italics indicate in this type of listing?
Most probably, your manual uses the italics to catch your attention so that you remember not to use 425.8 as a first-listed diagnosis. In its place, the italicized code represents a manifestation of another disease which you should code first. A note under 425.8 guides you to “code first underlying disease". Included in the list of underlying diseases is "sarcoidosis (135)."As such, on the claim you should list 135 first and use 425.8 as a secondary code.
Remember that 135 is one of the small number of valid three-digit ICD-9 codes. The code doesn’t have any fourth or fifth digit choices.
In the opening pages, you should find a guide to using your ICD-9 manual. For instance, page xii of the AMA’s 2010 professional edition (vol. 1 and 2) explains that the ‘code first’ instruction indicates an instructional note that directs the coder to sequence the underlying condition prior to the manifestation. To add to it, the manual makes use of a blue dot to the left of 425.8, and the manual guide explains, “The blue dot before a code indicates that the code should not be reported as the first-listed diagnosis.
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