Wednesday, September 14, 2011

ICD-9 Coding: Changes for Hemophilia, LEMS, and Anaphylaxis & More

With less than a month to go for the proposed changes for ICD-9 2012 to go into effect, here's a rundown on the codes that'll have a say on your oncology and hematology claims.

This time, the list of proposed ICD-9 codes is fairly short; but even then quite a few of them apply to your oncology and hematology claims. Here's what you need to watch out for:

Bansal and Squamous Cell

The proposed changes to ICD-9 medical codes 2012 include an expansion of 173.x. Each code in that series will get fifth digit choices, which will provide further details of the skin neoplasm type. The revisions in the 173.xx skin cancer codes follow a pattern where:




  • The fifth digit "0" refers to an unspecified malignant neoplasm
  • "1" denotes basal cell cancer (BCC)
  • "2" refers to squamous cell carcinoma (SCC)
  • "9" describes "other" specified malignant neoplasm.

  • Better documentation need of the hour: You will need to improve documentation as it'll allow you to code these conditions more specifically starting October 2011. In fact, this will also stand you in good stead when you switch to ICD-10.
    Own code for hemophilia

    You should also plan for the soon-to-go-into-effect ICD-9 codes to expand current four-digit code 286.5 into a new range of five-digit codes: 286.52, Acquired hemophilia, 286.53, Antiphospholipid antibody with hemorrhagic disorder, 286.59, Other hemorrhagic disorder due to intrinsic circulating anticoagulants, antibodies, or inhibitors.

    These changes will allow for more specific identification. It'll also help track trials on the cause, self-correction, and pharmaceutical treatment of these disease types of hemophilia.

    Three new codes related to LEMS

    ICD-9 2012 is likely to add three new codes pertaining to Lambert-Eaton myasthenic syndrome (LEMS): 358.30, Lambert-Eaton syndrome, unspecified, 358.31, Lambert-Eaton syndrome in neoplastic disease, 358.39, Lambert-Eaton syndrome in other diseases classified elsewhere.

    Right now, LEMs falls under 358.1. The code has an instruction to code first underlying disease. Say for instance, you may select the proper malignant neoplasm code from 140.0-208.9.

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