Monday, August 26, 2013

Don’t assume ICD-10 diagnosis codes -- 424.1 will split under the new cardiology codes next year

 The coming year there will be major code changes when ICD-10 comes into effect. Like any other practice there will be major changes for cardiology codes. For instance, there will be new code set divides for diagnosis code 424.1 under ICD 9-CM that is used to report aortic valve disorders, and you need to ensure that you are updated with all the code changes to keep your practice compliant and profitable. A disorder of the aortic valve refers to a problem with the valve between the aorta and the left ventricle.

When ICD-10 becomes effective then there will be a range of codes specifying 424.1 that will be from 135.0 – 135.9. There will be a range of codes to choose from for multiple aortic valve disorder codes in the I35. - range under ICD-10. ICD-10 will have separate codes for stenosis, insufficiency, stenosis with insufficiency, other, and unspecified.

To ensure correct coding you need to ensure that you document correctly if the aortic valve disease is rheumatic or not. You also need to ensure that you have adequate knowledge regarding whether the condition is congenital because it will affect the choice of codes that will be used. Since there will be multiple code options for aortic valve disorders under ICD-10, documentation needs to be specific about the type of disorder to identify the most specific code.

There are some tips that can be followed to code correctly. If the documentation shows stenosis and insufficiency then only the code 135.2 should be used instead of I35.0 and I35.1 together. Insufficiency can also be documented by using incompetence or regurgitation. When 135.8 is used the term “other” specifies that the physician documented the type, but ICD-10 will not have any code that will specify the documented type. The "unspecified" in I35.9 would mean that the physician did not document the type.