ICD-10: PSA Screenings and Ureteral Stone Diagnoses

When ICD-9 to ICD-10 transition takes place in 2013, you will not always have an easy one-to-one relationship between old codes and the new codes. See how your ICD-9 codes will change in the following instances when the ICD-10 transition finally takes place.

V Code for Z Code on PSA Screenings

You'll discover a one-to-one relationship for both screening as well as diagnostic PSA diagnoses.

While your urologist carries out a prostate specific antigen (PSA) test, you'll report either screening PSA using diagnosis code V76.44 (Special screening for malignant neoplasms; prostate) or diagnostic PSA code, (Elevated prostate specific antigen [PSA]). When ICD-9 codes change to ICD-10 codes, you'll still have one screening diagnosis code and one eminent PSA diagnosis code.

ICD-10 difference: Once your urologist orders a screening PSA test to be carried out for a patient with no signs or symptoms of disease, you must use diagnosis code V76.44 as the reason for the test under ICD-9. With ICD-10, you'll report Z12.5 (Special screening for malignant neoplasms; prostate).

After your urologist orders a diagnostic PSA test and the documentation requires that the test result demonstrates an elevated PSA, you must report 790.93 as the ICD-9 diagnosis. Once ICD-10 comes around, you'll use R97.2 (Elevated prostate specific antigen [PSA]).

Physician documentation: Presently, the physician must identify whether the PSA test is a screening or diagnostic test. This won't change in 2013.

Coder tips: You'll scrap the V76.44 and 790.93 options and turn to Z12.5 and R97.2 as ICD-10 codes options in your ICD-10 manual.

ICD-10: 591: Increase Your Hydronephrosis Coding in 2013

Check the urologist's documentation for mention of infection for coding accuracy

Once your urologist documents that a patient is going through hydronephrosis, you report 591 (Hydronephrosis) -- which may involve any or all of the following mentioned clinical scenarios: early hydronephrosis, hydronephrosis along with an atrophic kidney, a functionless along with infected kidney, recurrent hydronephrosis, or a primary or secondary type of hydronephrosis.

When ICD-9 changes to ICD-10 in 2013, you'll still have single diagnosis code for atrophic, early, functionless, intermittent, primary, and secondary not somewhere else classified (NEC) hydronephrosis: N13.30 (Unspecified hydronephrosis). For additional specified kinds of hydronephrosis NEC, you'll use N13.39 (Other hydronephrosis).

ICD-10 difference: Once your urologist confirms the patient has hydronephrosis along with an infection, an obstruction, or a ureteral stricture you'll need to learn new ICD-10 codes. With ICD-10, you'll report one of the following:

• Including infection (including obstruction or stricture with infection) -- N13.6, (Pyonephrosis)
• Including obstruction by renal or ureteral calculus -- N13.2, (Hydronephrosis with renal and ureteral calculous obstruction)
• Including ureteral obstruction or stricture NEC -- N13.1, (Hydronephrosis with ureteral stricture, not elsewhere classified)

Once your urologist documents that a patient has congenital hydronephrosis, you have a one-to-one ICD-9 to ICD-10 code interchange. The ICD9 codes you use is 753.29 (Obstructive defects of renal pelvis and ureter, other) and the  ICD-10 code of Supercoder you'll use is Q62.0 (Congenital hydronephrosis).