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 guidelines. Show all posts
Showing posts with label ICD-10 guidelines. 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.
Friday, August 26, 2011
ICD-10 Updates: Check Out New Options for Thyroid Disorders
While coding for thyroid disorders, here's what you need to keep in mind when ICD-10 goes into effect on October 1, 2013.
Although general rules of coding for both the code sets - ICD-10 and ICD-9 - will remain the same except for some subcategory variations, you need to stay up to date with these ICD 10 coding changes.
When it comes to thyroid disorders, here's how ICD-10 changes will have a say in your coding.
About thyroid gland: The thyroid gland is located in the front part of the neck; it produces the thyroid hormone which is important to normal metabolism. These disorders range from:
Hyperthyroidism: The thyroid gland becomes overactive here. It produces excess thyroid hormone and speeds up the body's metabolism. For hyperthyroidism, ICD-9 presently uses 242.
Hypothyroidism: On the other hand, here the thyroid gland becomes underactive. This happens if the thyroid does not produce enough hormones. ICD-9 currently uses 244 to report this.
In ICD-10-CM( Source "http://www.supercoder.com/icd-10/"), thyroid gland disorders are classified to these categories: E00 (Congenital iodine-deficiency syndrome), E01 (Iodine-deficiency related thyroid disorders and allied conditions), E02 (Subclinical iodine-deficiency hypothyroidism), E03 (Other hypothyroidism),E04 ( Other nontoxic goiter), E05 (Thyrotoxicosis [hyperthyroidism), E06 (Thyroiditis) and E07 ( Other disorders of thyroid).
Difference between the two code sets when it comes to coding for thyroid disorders:
Even though the coding rules related to thyroid diseases will be generally the same in ICD-10-CM as in the present code set, ICD-10-CM will classify some conditions to different chapters or different blocks. Say for instance ICD-9-CM's code for postsurgical hypothyroidism is 244.0, which is in the hypothyroidism category. In the new code system, you will not locate postsurgical hypothyroidism under category E03. In its place, you'll code it with E89.0, which is under category E89.
Tips for coders: A patient recently underwent surgery and radiation therapy for her thyroid cancer. The physician tends to this patient and carries out a level-two evaluation & management (E/M) and diagnoses her with hypothyroidism caused by the recent treatments. In this situation, you should opt for a more specific ICD-9 code than E03.9. When the patient has recently underwent thyroid surgery radiation therapy that caused the hypothyroidism, select the fourth digit based on the most recent factor affecting the hypothyroidism. For example , if the patient had surgery recently, choose E89.0. And if the radiation therapy was more recent, ICD-10 guidelines state that you would choose the same code.
Although general rules of coding for both the code sets - ICD-10 and ICD-9 - will remain the same except for some subcategory variations, you need to stay up to date with these ICD 10 coding changes.
When it comes to thyroid disorders, here's how ICD-10 changes will have a say in your coding.
About thyroid gland: The thyroid gland is located in the front part of the neck; it produces the thyroid hormone which is important to normal metabolism. These disorders range from:
Hyperthyroidism: The thyroid gland becomes overactive here. It produces excess thyroid hormone and speeds up the body's metabolism. For hyperthyroidism, ICD-9 presently uses 242.
Hypothyroidism: On the other hand, here the thyroid gland becomes underactive. This happens if the thyroid does not produce enough hormones. ICD-9 currently uses 244 to report this.
In ICD-10-CM( Source "http://www.supercoder.com/icd-10/"), thyroid gland disorders are classified to these categories: E00 (Congenital iodine-deficiency syndrome), E01 (Iodine-deficiency related thyroid disorders and allied conditions), E02 (Subclinical iodine-deficiency hypothyroidism), E03 (Other hypothyroidism),E04 ( Other nontoxic goiter), E05 (Thyrotoxicosis [hyperthyroidism), E06 (Thyroiditis) and E07 ( Other disorders of thyroid).
Difference between the two code sets when it comes to coding for thyroid disorders:
Even though the coding rules related to thyroid diseases will be generally the same in ICD-10-CM as in the present code set, ICD-10-CM will classify some conditions to different chapters or different blocks. Say for instance ICD-9-CM's code for postsurgical hypothyroidism is 244.0, which is in the hypothyroidism category. In the new code system, you will not locate postsurgical hypothyroidism under category E03. In its place, you'll code it with E89.0, which is under category E89.
Tips for coders: A patient recently underwent surgery and radiation therapy for her thyroid cancer. The physician tends to this patient and carries out a level-two evaluation & management (E/M) and diagnoses her with hypothyroidism caused by the recent treatments. In this situation, you should opt for a more specific ICD-9 code than E03.9. When the patient has recently underwent thyroid surgery radiation therapy that caused the hypothyroidism, select the fourth digit based on the most recent factor affecting the hypothyroidism. For example , if the patient had surgery recently, choose E89.0. And if the radiation therapy was more recent, ICD-10 guidelines state that you would choose the same code.
Thursday, August 11, 2011
ICD-10 Updates: Combination Code for Coronary Atherosclerosis With Angina Pectoris
In a couple of years' time, when you start using ICD-10 codes, watch out for a combination code that covers more than one diagnosis.
For the uninitiated, atherosclerosis is a type of arteriosclerosis characterized by fatty plague deposits that restricts the blood flow through the arteries. Angina pectoris refers to chest pain or discomfort caused by coronary heart disease.
When you report coronary arteriosclerosis in ICD-10-CM, you will notice some differences from the present ICD-9-CM coding. As already mentioned, when you hop into the ICD-10 bandwagon, you should be ready for a combination code that covers more than one diagnosis:
ICD-10 combines your coding for native coronary atherosclerosis and angina pectoris.
Under ICD-9-CM, you use 414.01, coronary atherosclerosis of native coronary artery
Under ICD-10-CM , you will use I25.10, I25.110, I25.111, I25.118, and I25.119.
So what's different between the two code sets: The main change ICD-10 will bring is that they differ based on 'without' (I25.10) and "with" (I25.11-) angina pectoris.
ICD-10 rules, just like its predecessor ICD-9, indicate you should report an additional code (I25.82) if the patient also suffers from chronic total occlusion of a coronary artery. To add to it, if the patient has coronary atherosclerosis because of lipid rich plague, you should go for I25.83. For codes in the range for ischemic heart diseases (I20- I25), you should go for an additional code to identify presence of hypertension (I10-I15).
Clinicians should know that the presence of angina pectoris will alter your native coronary artery disease coding. While documenting, they should be specific about whether the angina pectoris is unstable, with documented spasm or for that matter another form. Documentation should also point to whether the patient has chronic hypertension, total coronary occlusion, and/or coronary atherosclerosis caused by lipid rich plaque.
Tips for coders: Modify coding tools; bear in mind that ICD-10 offers a combination code for coronary atherosclerosis with angina pectoris.
Source Code :- http://www.supercoder.com
For the uninitiated, atherosclerosis is a type of arteriosclerosis characterized by fatty plague deposits that restricts the blood flow through the arteries. Angina pectoris refers to chest pain or discomfort caused by coronary heart disease.
When you report coronary arteriosclerosis in ICD-10-CM, you will notice some differences from the present ICD-9-CM coding. As already mentioned, when you hop into the ICD-10 bandwagon, you should be ready for a combination code that covers more than one diagnosis:
ICD-10 combines your coding for native coronary atherosclerosis and angina pectoris.
Under ICD-9-CM, you use 414.01, coronary atherosclerosis of native coronary artery
Under ICD-10-CM , you will use I25.10, I25.110, I25.111, I25.118, and I25.119.
So what's different between the two code sets: The main change ICD-10 will bring is that they differ based on 'without' (I25.10) and "with" (I25.11-) angina pectoris.
ICD-10 rules, just like its predecessor ICD-9, indicate you should report an additional code (I25.82) if the patient also suffers from chronic total occlusion of a coronary artery. To add to it, if the patient has coronary atherosclerosis because of lipid rich plague, you should go for I25.83. For codes in the range for ischemic heart diseases (I20- I25), you should go for an additional code to identify presence of hypertension (I10-I15).
Clinicians should know that the presence of angina pectoris will alter your native coronary artery disease coding. While documenting, they should be specific about whether the angina pectoris is unstable, with documented spasm or for that matter another form. Documentation should also point to whether the patient has chronic hypertension, total coronary occlusion, and/or coronary atherosclerosis caused by lipid rich plaque.
Tips for coders: Modify coding tools; bear in mind that ICD-10 offers a combination code for coronary atherosclerosis with angina pectoris.
Source Code :- http://www.supercoder.com
Wednesday, August 3, 2011
Under ICD-10-CM, Obstructive Sleep Apnea Gets a New Code - G47.33
As the October 1, 2013 ICD-10 deadline approaches, it's very important that you have a sound ICD-10 coding know how. If you are an otolaryngology coder, here are some ICD-10 guidelines that'll stand you in good stead.
Obstructive sleep apnea: Snoring, restless sleep, etc are manifestations of sleep-disordered breathing. The main disorders that may need surgical intervention are snoring and obstructive sleep apnea (OSA). In obstructive sleep apnea, pauses in breathing (more than 10 seconds at a time) take place because the airway becomes narrowed, blocked or floppy. This disorder may differ in severity and is normally associated with other physiologic problems.
Ways to diagnose OSA? An otolaryngologist will provide a thorough examination of the nose, mouth, throat, palate, and neck, many a time using a fiberoptic scope. Under ICD-9-CM code set, if the patient was diagnosed with obstructive sleep apnea, you would go for 327.23 (obstructive sleep apnea –adult – pediatric).
Transition from ICD-9 to ICD-10 codes : However, after the transition to ICD-10 on October 1, 2013, you would not report 327.23 for OSA as 327.23 becomes G47.33. This change will offer no difference; as a matter of fact, the descriptor of the new code is a carbon copy depiction of the previous code set's 327.23.
Documentation: While diagnosing a sleep disorder like obstructive sleep apnea, a physician may have the patient fill out a questionnaire to get information on wake-sleep patterns. Blood tests may also be ordered to rule out other conditions. If the physician suspects a sleep disorder, the patient would most probably undergo a polysomnography to record breathing and brain and muscle during sleep. Depending on the specific type of disorder, treatment will be provided.
Obstructive sleep apnea: Snoring, restless sleep, etc are manifestations of sleep-disordered breathing. The main disorders that may need surgical intervention are snoring and obstructive sleep apnea (OSA). In obstructive sleep apnea, pauses in breathing (more than 10 seconds at a time) take place because the airway becomes narrowed, blocked or floppy. This disorder may differ in severity and is normally associated with other physiologic problems.
Ways to diagnose OSA? An otolaryngologist will provide a thorough examination of the nose, mouth, throat, palate, and neck, many a time using a fiberoptic scope. Under ICD-9-CM code set, if the patient was diagnosed with obstructive sleep apnea, you would go for 327.23 (obstructive sleep apnea –adult – pediatric).
Transition from ICD-9 to ICD-10 codes : However, after the transition to ICD-10 on October 1, 2013, you would not report 327.23 for OSA as 327.23 becomes G47.33. This change will offer no difference; as a matter of fact, the descriptor of the new code is a carbon copy depiction of the previous code set's 327.23.
Documentation: While diagnosing a sleep disorder like obstructive sleep apnea, a physician may have the patient fill out a questionnaire to get information on wake-sleep patterns. Blood tests may also be ordered to rule out other conditions. If the physician suspects a sleep disorder, the patient would most probably undergo a polysomnography to record breathing and brain and muscle during sleep. Depending on the specific type of disorder, treatment will be provided.
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