Does 'Endometrial thickening' mean you should report these codes? Well, not necessarily.
The switch from ICD-9 to ICD-10 represents one of the most extensive impacts to a healthcare provider's business. So if the very thought of the dramatic increase in codes worries you, rest assured. You'll find simple one-to-one relationships between old and new codes.
That is also the case for hyperplasia; however you need to beware. You'll still need to carry over the same coding conventions.
Say for example your ob-gyn suspects hyperplasia. He traces and documents 'endometrial thickening' during an ultrasound examination; keeping this mind, what diagnosis should you report here?
Many coders all prey to this mistake
Just because your ob-gyn documents endometrial thickening doesn't mean the patient has endometrial hyperplasia. Many coders fall prey to this. (621.30 or 621.31).
ICD-10 Updates: Remember this snag. If you come face to face with the same situation in 2013, you shouldn't go for the straight forward hyperplasia equivalents N8500 (Endometrial hyperplasia, unspecified) and N8501 (Simple endometrial hyperplasia without atypia). These definitions are exactly the same.
ICD-10 Coding Tips: You should not be carried away by 'endometrial thickening'. Don't code this as hyperplasia because physicians do not always take the thickening of the uterus 'abnormal'; as a matter of fact, it is just a monthly ramp up for all women. You should not report hyperplasia until and unless the ob-gyn has carried out a biopsy and you have at hand a pathology report that corroborates this condition.
Way out: Since you have no code to describe the patient's condition, you should go for 793.5. Since endometrial thickening is a finding and not a diagnosis, you should locate the diagnosis code in the signs and symptoms section of ICD-0. If you look under thickened endometrium, this will take you to 793.5.
You will not see 'thickened endometrium' referenced at all; therefore you'd normally rely on the options given by one of the equivalent tables that have been produced based on the ICD-9 code 793.5.
Watch Out: If you look up the equivalent ICD-10 code for 793.5, you will find that the national Center for Health Statistics still lists R93.4; this is wrong as the uterus is not a urinary organ.
For more ICD-10 guidelines and updates, sign up for a one-stop medical coding guide like SuperCoder. Such a site comes with packed with all the information you need about ICD-10 to make a smooth transition.
Showing posts with label ICD-10 coding. Show all posts
Showing posts with label ICD-10 coding. Show all posts
Monday, September 19, 2011
Thursday, September 15, 2011
G47.33 Replaces 327.23 Under ICD-10-CM
When ICD-10 codes go into effect, similar functioning code in the I-10 G Suffix replaces 327.23.
In order to diagnose obstructive sleep apnea (OSA), an otolaryngologist will provide a complete inspection of the nose, mouth, throat, palate and neck, many a time using a fiberoptic scope. Right now, you would code 327.23 for patients suffering from OSA.
Difference in ICD-10 coding: So now under ICD-9-CM code set, when a patient gets diagnosed with obstructive sleep apnea, you will go for 327.23. However after a couple of years, when ICD-10 goes into effect, this code will become G47.33. This change to ICD-10 will not offer any difference. As a matter of fact, G47.33's descriptor is a carbon copy depiction of ICD-9's 327.23.
While diagnosing a sleep disorder such as OSA, a physician may have the patient fill up a questionnaire in order to obtain information on patterns of wake-sleep. That apart, she may also order blood tests to rule out other conditions. If the physician suspects a sleep disorder, the patient would most likely go through a polysomnography to record breathing and brain and muscle during sleep. Treatment will depend on the specific type of disorder, and if there's an underlying cause.
ICD-10 tips: One of the ways an otolaryngologist can lessen this potentially life-threatening condition is with genioglossus advancement. This procedure involves the surgeon creating a small bone window in front of the lower jaw, and then pulls the tendons that fix the front of the tongue to the jaw forward onto a bone fragment. This leads to a larger airway between the back of the tongue and the throat, and results in easier breathing for obstructive sleep apnea patients.
You would code mandibular segmental osteotomy with genioglossus advancement with 21199 when carried out to treat obstructive sleep apnea.
For more ICD-10 updates and ICD-10 guidelines, sign up for a good Medical coding resource.
In order to diagnose obstructive sleep apnea (OSA), an otolaryngologist will provide a complete inspection of the nose, mouth, throat, palate and neck, many a time using a fiberoptic scope. Right now, you would code 327.23 for patients suffering from OSA.
Difference in ICD-10 coding: So now under ICD-9-CM code set, when a patient gets diagnosed with obstructive sleep apnea, you will go for 327.23. However after a couple of years, when ICD-10 goes into effect, this code will become G47.33. This change to ICD-10 will not offer any difference. As a matter of fact, G47.33's descriptor is a carbon copy depiction of ICD-9's 327.23.
While diagnosing a sleep disorder such as OSA, a physician may have the patient fill up a questionnaire in order to obtain information on patterns of wake-sleep. That apart, she may also order blood tests to rule out other conditions. If the physician suspects a sleep disorder, the patient would most likely go through a polysomnography to record breathing and brain and muscle during sleep. Treatment will depend on the specific type of disorder, and if there's an underlying cause.
ICD-10 tips: One of the ways an otolaryngologist can lessen this potentially life-threatening condition is with genioglossus advancement. This procedure involves the surgeon creating a small bone window in front of the lower jaw, and then pulls the tendons that fix the front of the tongue to the jaw forward onto a bone fragment. This leads to a larger airway between the back of the tongue and the throat, and results in easier breathing for obstructive sleep apnea patients.
You would code mandibular segmental osteotomy with genioglossus advancement with 21199 when carried out to treat obstructive sleep apnea.
For more ICD-10 updates and ICD-10 guidelines, sign up for a good Medical coding resource.
Tuesday, September 13, 2011
ICD-10 Codes: Be Selective while Reporting G89 Category Codes
When ICD-10 goes into effect in a couple of years' time, you need to learn to apply G89 category as it is the key to getting your pain diagnoses right.
Important ICD-10 coding tip: You should be selective in reporting the codes from the G89 category codes. If the definitive diagnosis is established, these codes are never assigned. The only exception happens to be when the reason for the encounter is pain control and not the management of the underlying condition.
You need to combine G89 with site-specific pain codes
You can report the G89 category code along with codes that identify the site of pain; the two codes can be sequenced as per the circumstances.
One-to-one match for several pain codes
The soon to go into effect coding system has a one-to-one match for various pain codes in the current code set. Here are the choices you will have post October 1, 2013.
ICD-9's 338.18 corresponds to G89.18 in ICD-10. Likewise, 338.28 corresponds to G89.28 in ICD-10. In these pairs, there's a change from 'postoperative' to 'postprocedure'. G89.18 covers both postoperative pain NOS as well as postprocedural pain NOS. The inclusion of postprocedure pain acknowledges those circumstances where a procedure, say for instance lumbar puncture or other percutaneous treatment leads to acute or chronic pain.
You should include psychological factors
We know pain is an emotional experience. As such there may be an accompanying psychological component which you should not miss out on. F45.42 which corresponds to 307.89 in ICD-9 is ICD-10 code for the psychological factors. See to it that you have supporting documents for the psychological factors. you have Excludes 1 and Excludes 2 information under G89 and the bottom of the Excludes 2 information urges you to report F45.42 for psychological factors. If you make use of the index and take a look under pain, you'll find psychogenic pain that'll guide you to the code.
Note: You should also use the index and then check the tabular for the right code.
Important ICD-10 coding tip: You should be selective in reporting the codes from the G89 category codes. If the definitive diagnosis is established, these codes are never assigned. The only exception happens to be when the reason for the encounter is pain control and not the management of the underlying condition.
You need to combine G89 with site-specific pain codes
You can report the G89 category code along with codes that identify the site of pain; the two codes can be sequenced as per the circumstances.
One-to-one match for several pain codes
The soon to go into effect coding system has a one-to-one match for various pain codes in the current code set. Here are the choices you will have post October 1, 2013.
ICD-9's 338.18 corresponds to G89.18 in ICD-10. Likewise, 338.28 corresponds to G89.28 in ICD-10. In these pairs, there's a change from 'postoperative' to 'postprocedure'. G89.18 covers both postoperative pain NOS as well as postprocedural pain NOS. The inclusion of postprocedure pain acknowledges those circumstances where a procedure, say for instance lumbar puncture or other percutaneous treatment leads to acute or chronic pain.
You should include psychological factors
We know pain is an emotional experience. As such there may be an accompanying psychological component which you should not miss out on. F45.42 which corresponds to 307.89 in ICD-9 is ICD-10 code for the psychological factors. See to it that you have supporting documents for the psychological factors. you have Excludes 1 and Excludes 2 information under G89 and the bottom of the Excludes 2 information urges you to report F45.42 for psychological factors. If you make use of the index and take a look under pain, you'll find psychogenic pain that'll guide you to the code.
Note: You should also use the index and then check the tabular for the right code.
Friday, August 19, 2011
ICD-10 Updates: Report ‘Other’ and ‘Unspecified’ Hyperlipidemia Separately
ICD-10 offers a one-to-one code match with the previous code set for pure hypercholesterolemia, pure hyperglyceridemia, and mixed hyperlipidemia. Read on for a comparative study of how coding for the two code sets will affect you.
When ICD-10 goes into effect on October 1, 2013, there are good chances that high cholesterol will still be a hurdle for your patients. Take a look at how coding for this and similar diagnoses compares between the two code sets (ICD-9 and ICD-10).
ICD-9-CM codes include 272.0, 272.1, 272.2 and 272.4 while soon to go into effect ICD-10-CM codes include E78.0, E78.1, E78.2, E78.4, and E78.5.
ICD-10 coding changes
ICD-10 offers a one-to-one code match with ICD-9 for pure hypercholesterolemia (272.0, E78.0), pure hyperglyceridemia (272.1, E78.1), and mixed hyperlipidemia (272.2, E78.2). However where ICD-9 code offers one code for 'other and unspecified hyperlipidemia" (272.4), ICD-10 offers one code for 'other' E78.4) and a different code for “unspecified" (E78.5).
Don't change your clinicians' documentation from its present form
When it comes to clinicians' documentation you should not change it from its present form. All that you need to do as a coder to capture this already existing information is to format your superbill to capture the difference between 'other' and 'unspecified' hyperlipidemia. By 'others' it means the physician documented the type; however the new code set does not offer a code specific to the documented type. By 'Unspecified' it means that the physician didn't document the type of hyperlipidemia.
Differences between ICD-9 and ICD-10 codes for lipid metabolism disorders
Although the notes with the ICD-9 and ICD-10 codes for lipid metabolism disorders are very similar, there are a few differences though.
Example: Say for instance while 272.1 includes “hypertriglyceridemia, essential," E78.1 includes “elevated fasting triglycerides." Under E78.2, ICD-10 adds 'combined hyperlipidemia NOS', elevated cholesterol with elevated triglycerides NEC and “Hyperlipidemia, group C. Code E78.2 also has an Excludes1 note, asking you to code E78.4 for “familial combined hyperlipidemia" and E78.5 for “cerebrotendinous cholesterosis".
Bear in mind: When the new code system goes into effect on October 1, 2013, you should apply the code set and official guidelines in effect for the date of service (DOS) reported. (You can get more information here www.cdc.gov/nchs/icd/icd10cm.htm#10update.).
When ICD-10 goes into effect on October 1, 2013, there are good chances that high cholesterol will still be a hurdle for your patients. Take a look at how coding for this and similar diagnoses compares between the two code sets (ICD-9 and ICD-10).
ICD-9-CM codes include 272.0, 272.1, 272.2 and 272.4 while soon to go into effect ICD-10-CM codes include E78.0, E78.1, E78.2, E78.4, and E78.5.
ICD-10 coding changes
ICD-10 offers a one-to-one code match with ICD-9 for pure hypercholesterolemia (272.0, E78.0), pure hyperglyceridemia (272.1, E78.1), and mixed hyperlipidemia (272.2, E78.2). However where ICD-9 code offers one code for 'other and unspecified hyperlipidemia" (272.4), ICD-10 offers one code for 'other' E78.4) and a different code for “unspecified" (E78.5).
Don't change your clinicians' documentation from its present form
When it comes to clinicians' documentation you should not change it from its present form. All that you need to do as a coder to capture this already existing information is to format your superbill to capture the difference between 'other' and 'unspecified' hyperlipidemia. By 'others' it means the physician documented the type; however the new code set does not offer a code specific to the documented type. By 'Unspecified' it means that the physician didn't document the type of hyperlipidemia.
Differences between ICD-9 and ICD-10 codes for lipid metabolism disorders
Although the notes with the ICD-9 and ICD-10 codes for lipid metabolism disorders are very similar, there are a few differences though.
Example: Say for instance while 272.1 includes “hypertriglyceridemia, essential," E78.1 includes “elevated fasting triglycerides." Under E78.2, ICD-10 adds 'combined hyperlipidemia NOS', elevated cholesterol with elevated triglycerides NEC and “Hyperlipidemia, group C. Code E78.2 also has an Excludes1 note, asking you to code E78.4 for “familial combined hyperlipidemia" and E78.5 for “cerebrotendinous cholesterosis".
Bear in mind: When the new code system goes into effect on October 1, 2013, you should apply the code set and official guidelines in effect for the date of service (DOS) reported. (You can get more information here www.cdc.gov/nchs/icd/icd10cm.htm#10update.).
Wednesday, July 27, 2011
New ICD-10 Coding Conventions You Should Be Aware Of
Here are a few things you need to keep in mind as you make the transition from ICD-9 to ICD-10.
Excludes may include two different things
When you switch to ICD-10, one key change you'll see is 'excludes' will be of two types. Initially, this might seem like more burden to your coding work; however, this will only ease your work by getting rid of one of ICD-9's mistakes.
'X' or "X?" in your code listing? Well, this is here to help you
When you get hold of your ICD-10 manual, you will notice certain codes that include an 'X' or an "X?" in them – however don't assume that it's a printing error as it is there to assist you.
Whether left side or right side was treated while dealing with some anatomic areas
Worried about your ICD-10 manual ( Source "http://www.supercoder.com/icd-10/") being thicker than the ICD-9 book? Don't be. Because much of the book's additions are owing to the fact that many codes will require you to denote whether the left side or right side was treated while dealing with certain anatomic areas – it could be eyes, ears, hands, hands, feet, ovaries, and the like.
Right now, when you report acute atopic conjunctivitis, you use 372.05. In some rare examples, when insurers want to figure out which eye was affected, you add the RT or LT modifiers. When you make the transition, you will not only signify the specific type of conjunctivitis by reporting the most spot on diagnosis code, but will also have to specify which eye was affected. As such, depending on the eye infected, an acute atopic conjunctivitis diagnosis could track to one of these codes: H10.10, H10.11, H10.12 and H10.13.
Excludes may include two different things
When you switch to ICD-10, one key change you'll see is 'excludes' will be of two types. Initially, this might seem like more burden to your coding work; however, this will only ease your work by getting rid of one of ICD-9's mistakes.
'X' or "X?" in your code listing? Well, this is here to help you
When you get hold of your ICD-10 manual, you will notice certain codes that include an 'X' or an "X?" in them – however don't assume that it's a printing error as it is there to assist you.
Whether left side or right side was treated while dealing with some anatomic areas
Worried about your ICD-10 manual ( Source "http://www.supercoder.com/icd-10/") being thicker than the ICD-9 book? Don't be. Because much of the book's additions are owing to the fact that many codes will require you to denote whether the left side or right side was treated while dealing with certain anatomic areas – it could be eyes, ears, hands, hands, feet, ovaries, and the like.
Right now, when you report acute atopic conjunctivitis, you use 372.05. In some rare examples, when insurers want to figure out which eye was affected, you add the RT or LT modifiers. When you make the transition, you will not only signify the specific type of conjunctivitis by reporting the most spot on diagnosis code, but will also have to specify which eye was affected. As such, depending on the eye infected, an acute atopic conjunctivitis diagnosis could track to one of these codes: H10.10, H10.11, H10.12 and H10.13.
Thursday, April 28, 2011
394.2's ICD-10 Replacement Specifies 'Rheumatic'
I05.2 gives you a good lesson in why your superbill's font matters.
Valve disease diagnosis codes are confusing without a doubt. Get a head start on mastering these diagnoses under ICD-10 with a look at how one of your ICD-9 choices will change when ICD-10 goes into effect in a couple of years' time.
394.2- (Mitral stenosis with insufficiency) - ICD 9 CM code
I05.2- (Rheumatic mitral stenosis with insufficiency) - ICD 10 CM code
Dx definition: Mitral stenosis refers to narrowing (stenosis) of the heart's mitral valve, situated between the left atrium and left ventricle. When the doctor additionally documents insufficiency (or incompetence or regurgitation), you should take a look at the codes listed above. "Rheumatic" happens to be a reference to rheumatic fever, a disease which may end up in heart damage.
Rheumatic: 394.2 is not specific to "rheumatic" mitral stenosis with insufficiency. The ICD-10 descriptor for 105.2 includes the term 'rheumatic', however the 'includes' note under I05 (Rheumatic mitral valve disease) specifies that the range is proper for conditions 'whether specified as rheumatic or not'. Therefore of the documentation specifies the case is rheumatic or if it does not mention the cause, I05.2 will be proper. On the contrary, of the documentation states the disease isn't rheumatic, you'll go for a code from I34.-.
Multiple valve involvement: For 394.x (Diseases of mitral valve), ICD-9 has an excludes note telling you to instead use 396.x if the patient also has aortic valve involvement.
Likewise, ICD-10 guides you to use a different code range (not I05.-) for mitral valve disease if there's aortic valve involvement. You'll instead use I08.- (Multiple valve diseases). This is the same range ICD-10 guides you to use if the patient has tricuspid valve involvement apart from mitral valve disease.
Documentation: In order to ensure you'll be able to choose the most proper ICD-10 code, your clinicians' documentation must point to whether the condition is rheumatic. Also it should specify whether the mitral valve alone is involved.
When you make your ICD-10 coding tools, ensure the "rheumatic/nonrheumatic/unspecified" rules clear, and refer coders to I34.- for non-rheumatic cases. Similarly emphasize that I05.2 is for mitral disease only. If other valves are concerned, the proper code will be found in the I08.- range.
Tip: Just as 394.2, I05.2 is right for mitral stenosis with incompetence or regurgitation; as such stay alert for those terms.
As such, is that a 1 or an I? A 0 or an O? You should distinguish between similar looking characters when you are assigning ICD-10 codes. Code I05.2 is great example of a code that comprises easily confused characters. Bear in mind that your first character is a letter and will be followed by digits. As such I05.2 is the letter "I" followed by the number "0."
Bear in mind: When ICD-10 goes into effect, you should apply the code set and official guidelines in effect for the DOS reported.
Source URL :- http://www.supercoder.com/coding-newsletters/my-cardiology-coding-alert/icd-10-3942s-replacement-specifies-rheumatic-get-the-details-here-article
Valve disease diagnosis codes are confusing without a doubt. Get a head start on mastering these diagnoses under ICD-10 with a look at how one of your ICD-9 choices will change when ICD-10 goes into effect in a couple of years' time.
394.2- (Mitral stenosis with insufficiency) - ICD 9 CM code
I05.2- (Rheumatic mitral stenosis with insufficiency) - ICD 10 CM code
Dx definition: Mitral stenosis refers to narrowing (stenosis) of the heart's mitral valve, situated between the left atrium and left ventricle. When the doctor additionally documents insufficiency (or incompetence or regurgitation), you should take a look at the codes listed above. "Rheumatic" happens to be a reference to rheumatic fever, a disease which may end up in heart damage.
Rheumatic: 394.2 is not specific to "rheumatic" mitral stenosis with insufficiency. The ICD-10 descriptor for 105.2 includes the term 'rheumatic', however the 'includes' note under I05 (Rheumatic mitral valve disease) specifies that the range is proper for conditions 'whether specified as rheumatic or not'. Therefore of the documentation specifies the case is rheumatic or if it does not mention the cause, I05.2 will be proper. On the contrary, of the documentation states the disease isn't rheumatic, you'll go for a code from I34.-.
Multiple valve involvement: For 394.x (Diseases of mitral valve), ICD-9 has an excludes note telling you to instead use 396.x if the patient also has aortic valve involvement.
Likewise, ICD-10 guides you to use a different code range (not I05.-) for mitral valve disease if there's aortic valve involvement. You'll instead use I08.- (Multiple valve diseases). This is the same range ICD-10 guides you to use if the patient has tricuspid valve involvement apart from mitral valve disease.
Documentation: In order to ensure you'll be able to choose the most proper ICD-10 code, your clinicians' documentation must point to whether the condition is rheumatic. Also it should specify whether the mitral valve alone is involved.
When you make your ICD-10 coding tools, ensure the "rheumatic/nonrheumatic/unspecified" rules clear, and refer coders to I34.- for non-rheumatic cases. Similarly emphasize that I05.2 is for mitral disease only. If other valves are concerned, the proper code will be found in the I08.- range.
Tip: Just as 394.2, I05.2 is right for mitral stenosis with incompetence or regurgitation; as such stay alert for those terms.
As such, is that a 1 or an I? A 0 or an O? You should distinguish between similar looking characters when you are assigning ICD-10 codes. Code I05.2 is great example of a code that comprises easily confused characters. Bear in mind that your first character is a letter and will be followed by digits. As such I05.2 is the letter "I" followed by the number "0."
Bear in mind: When ICD-10 goes into effect, you should apply the code set and official guidelines in effect for the DOS reported.
Source URL :- http://www.supercoder.com/coding-newsletters/my-cardiology-coding-alert/icd-10-3942s-replacement-specifies-rheumatic-get-the-details-here-article
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