Focus On Drug Dependence versus Abuse to Assign Diagnosis

ICD-9 does not provide a specific code for a urine drug test. The same is the case with ICD-10 too. The proper diagnosis code for billing a lab drug test depends on the signs, symptoms, patient condition, or other reason for the test, say for instance screening.

Example: The physician orders a drug screen for a patient diagnosed with Cannabis dependence who uses the drug intermittently. Code the ordering diagnosis as 304.32 (Cannabis dependence, episodic use) with ICD-9.

Cross walking from ICD-9 to ICD-10: Even though ICD-10 provides more detail than ICD-9, leading to more code choices for ICD-10, the opposite is correct in this instance. The subsequent three ICD-9 codes crosswalk to a single ICD-10 code (F12.20, Cannabis dependence, uncomplicated):

304.30 -- Cannabis dependence, unspecified use

304.31 -- Cannabis dependence, continuous use

304.32 -- Cannabis dependence, episodic use.

Report different codes for abuse or use

Both ICD-9 as well as ICD-10 differentiates between drug dependence versus drug abuse. For example, 304.3x identifies Cannabis dependence while 305.2x (Non-dependent Cannabis abuse) identifies Cannabis abuse.

Likewise, ICD-10 provides F12.20 for Cannabis dependence, and F12.10 (Cannabis abuse, uncomplicated) for Cannabis abuse.

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What's more, ICD-10 provides separate codes for drug use when the doctor does not specify whether the use constitutes dependence or abuse. For example, you would code Cannabis use as F12.90 (Cannabis use, unspecified, uncomplicated).

New Choice to Boost your Diagnosis Coding

ICD-9 Codes 2011 going to effect in October, and here new ‘attention deficit’ to boost your Diagnosis Coding

The 2011 ICD-9 codes going into effect on October 1 have a few welcome additions for younger patients. Here are some examples of new diagnoses you could find yourself reporting on a regular basis.

Attention deficit options provide a better starting point ICD-9 2011 adds the 799.5x family to the ‘I’ll defined and unknown causes of morbidity and mortality’ section. The just-arrived codes include:

799.51 -- Attention or concentration deficit

799.52 -- Cognitive communication deficit

799.53 -- Visuospatial deficit

799.54 -- Psychomotor deficit

799.55 -- Frontal lobe and executive function deficit

799.59 -- Other signs and symptoms involving cognition.

This new series will be useful for symptoms and signs as a diagnosis before the doctor establishes a definitive diagnosis. Physicians treat children with concerns regarding attention or activity. You do not have sufficinet information after the first visit for an official diagnosis; but then you still need something to report.

V codes address retained fragments

ICD-9 2011 also comes up with a series of specific V codes for diferent types of retained fragments. The series (V90.01- V90.9) address objects ranging from metal, plastic or wood to animal quills or spines, glass, teeth, and other specified foreign bodies, including radioactive fragments.

Remember that you won’t report a code for foreign body removal in conjunction with V90.x. These foreign bodies are retained. You will deal with it in terms of the patient’s history and physical, however not an actual procedure to remove the object.

Want to know more about these attention deficit choices and other 2011 ICD-9 code(http://www.supercoder.com/icd9-codes/) changes? Just stay tuned to a medical coding guide like Supercoder.