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 updates. Show all posts
Showing posts with label ICD-10 updates. 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.
Thursday, September 8, 2011
ICD-10 Updates: A Burn May Be Corrosion Under the Soon-To-Go-Into Effect Code Set
The new diagnosis coding system will allow your surgeon to make a distinction.
When you start using ICD-10 in October 2013, reporting burns by body site/ ‘degree’ plus an additional code for total body surface area (TBSA) won’t change. However, reporting the cause of the burn will.
Changes ICD-10 will bring to burn source
In ICD-9, a burn is a burn; however under ICD-10, a burn may be a corrosion, which is a chemical burn and the new diagnosis coding system will allow your surgeon to make a distinction.
Here’s an Instance:
A patient has a second degree burn of the right thigh from accidentally spilling boiling water. Under the present code system, you would report the condition as 945.26 whereas under ICD-10, you need to list T24.211.
Now let us say you have the exact scenario, except the burn is from an accidental spill of a strong acid. With the present code system, you’d still go for 945.26. However, you’ll use T24.611- (Corrosion of second degree of right thigh) for ICD-10.
ICD-10 helps you zoom in on body site more specifically than the current code set. ICD-10 provides distinct codes for you to report bilateral body sites as right, left or unspecified.
Additional codes
Just like ICD-9, you will need to list a distinct ICD-10 code pointing to the extent of burns (or corrosions) using a unique TBSA code.
Say for instance in ICD-9, you would go for 948.10. But after 2013, you will have two TBSA choices based on the burn/corrosion distinction: T31.10, T32.10.
Corrosion codes in ICD-10: After 2013, not only do you have different corrosion codes in the soon-to-go-into effect ICD-10 code set , you also need to report a unique code to determine the cause of the chemical burn. ICD-10 provides this instruction: Code first: (T51-T65) to identify chemical and intent preceding the corrosion codes.
When you start using ICD-10 in October 2013, reporting burns by body site/ ‘degree’ plus an additional code for total body surface area (TBSA) won’t change. However, reporting the cause of the burn will.
Changes ICD-10 will bring to burn source
In ICD-9, a burn is a burn; however under ICD-10, a burn may be a corrosion, which is a chemical burn and the new diagnosis coding system will allow your surgeon to make a distinction.
Here’s an Instance:
A patient has a second degree burn of the right thigh from accidentally spilling boiling water. Under the present code system, you would report the condition as 945.26 whereas under ICD-10, you need to list T24.211.
Now let us say you have the exact scenario, except the burn is from an accidental spill of a strong acid. With the present code system, you’d still go for 945.26. However, you’ll use T24.611- (Corrosion of second degree of right thigh) for ICD-10.
ICD-10 helps you zoom in on body site more specifically than the current code set. ICD-10 provides distinct codes for you to report bilateral body sites as right, left or unspecified.
Additional codes
Just like ICD-9, you will need to list a distinct ICD-10 code pointing to the extent of burns (or corrosions) using a unique TBSA code.
Say for instance in ICD-9, you would go for 948.10. But after 2013, you will have two TBSA choices based on the burn/corrosion distinction: T31.10, T32.10.
Corrosion codes in ICD-10: After 2013, not only do you have different corrosion codes in the soon-to-go-into effect ICD-10 code set , you also need to report a unique code to determine the cause of the chemical burn. ICD-10 provides this instruction: Code first: (T51-T65) to identify chemical and intent preceding the corrosion codes.
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.
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.).
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
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