ICD-10: 'Other Anomalies' Code 748.3 Will Expand to More Exact 'Other' Codes

Tip: You should be cautious while submitting probable diagnoses.

In case you use ICD-9 code 748.3 for your entire 'other' congenital abnormalities of the trachea as well as bronchi for conditions that are not otherwise stated in ICD-9, then you must be prepared to come across more specific 'other' codes in ICD-10. Most of them concentrate on the anatomical areas. Follow this expert medical billing and coding advice and know what codes you must report when ICD-9 to ICD-10 transition takes place.

Also mentioned as congenital deformities of the upper airway, the existing ICD-9 code includes:

• laryngomalacia – (a form of congenital laryngeal stridor characterized by flaccidity of the supraglottic structures);
• laryngeal cyst – (a mucus-filled dilatation of the laryngeal saccule which may distort the aryepiglottic fold, the false cord or the laryngeal ventricle_;
• laryngocoele – (an air-filled dilatation of the ventricular sinus of Morgagni);
• laryngeal web or glottis;
• Cri-du-chat syndrome;
• vocal cord paralysis;
• subglottic stenosis;
• subglottic haemangioma; and
• laryngotracheal cleft.

Abnormalities of the trachea as well as bronchi consist of agenesis, stenosis, tracheomalacia, vascular compression, vascular ring, bronchial bifurcations, as well as anterior/posterior compression.

Right now, in case a patient suffers from any of the conditions earlier enumerated, the ENT would probably diagnose her with "other congenital anomalies of larynx trachea and bronchus" which you would report with ICD-9 code 748.3 (Other congenital anomalies of larynx trachea and bronchus).

ICD-10 Change: When ICD-9 transitions to ICD-10 on Oct. 1, 2013, ICD-9 code 748.3 will expand into five more specific diagnosis codes:

• Q31.1 – (Congenital subglottic stenosis)
• Q31.3 – (Laryngocele)
• Q31.8 – (Other congenital malformations of larynx)
• Q32.1 – (Other congenital malformations of trachea)
• Q32.4 – (Other congenital malformations of bronchus)

This is an instance of why coders need to re-acquaint themselves with their anatomy and pathophysiology in preparation for the ICD-10 implementation.

Documentation: Keep in mind that you must code only the confirmed diagnoses. Besides, remember that you should not code "suspected," "rule out" or "probable" diagnoses. You may report codes that describe signs and symptoms, as opposed to diagnoses, when the ENT has not established a related definitive diagnosis.

Coder tips: Two of the commonly used CPT codes that an ENT would link to Q31.1, Q31.3, Q31.8, Q32.1, or Q32.4 are 31770 (Bronchoplasty; graft repair) and 31775 (Bronchoplasty; excision stenosis and anastomosis). A bronchoplasty is carried out with either graft repair or excision of a stenosis with anastomosis.