ICD-9 2012: Now 425.1 Will Fetch you Denials – Immediately!

The ICD-9 2012 codes went into effect on October 1 this year. But are you up to date with the list of ICD-9 codes for 2012? Read on and get more insight.

Coronary atherosclerosis and hypertrophic cardiomyopathy were late additions in ICD-9 2012. Here are some ICD-9 2012 changes you need to heed to. This year's codeset has added 414.4 (it helps single out coronary lesions) after a proposal for a unique code for severely calcified coronary lesions came to the fore. The idea behind the proposal was to be able to distinguish a calcified lesion from other ischemic lesions. Calcified lesions are not the same as lipid rich plaque and chronic total occlusions. Code 414.8 is too general to identify the nature of the lesion.

Now ICD-9 2012 features new coding choices for hypertrophic cardiomyopathy, from October 1, 2011. This is because Hypertrophic cardiomyopathy can have two levels of manifestation - obstructive or nonobstructive. Whether it is obstructive or not, can have a say on the need for different medical or surgical treatments.

Previously, under ICD-9 2011, 425.1 was a valid code (Hypertrophic obstructive cardiomyopathy). If you required to report nonobstructive hypertrophic cardiomyopathy, you used 425.4. Now, the update revises 425.1 so that it's no longer a valid code – you must add a fifth digit for it to be valid: 425.11, 425.18.

These ICD-9 changes give you one code for hypertrophic obstructive (425.11) and one more for other hypertrophic, including nonobstructive (425.18). In order to conform with the changes to the 425.1x range, ICD-9 deletes the terms "hypertrophic" and "nonobstructive" from under 425.4.

For the entire ICD-9 codes list , final revisions and for other ICD-9 code 2012 changes, sign up for a good coding resource like SuperCoder.

ICD-9 2012: Perfect your HTN Coding

ICD-9 2012 codes go into effect on October 1 this year. Like other practices, your cardiology practice too will be impacted by this year's list of ICD-9 codes. And since Hypertension (HTN) is on the rise in the US, it's essential that your HTN coding is top-quality. Or else many of your claims will be in the danger zone.

Here are some rules to polish your HTN coding to perfection:

Utilize the Hypertension Table: This Hypertension Table simplifies your search and can be found under the ICD-9 index entry "Hypertension". It not only shows the basic 401.x (Essential hypertension) codes but also the codes for conditions owing to or associated with HTN. What's more, the table helps clarify when you code choices differ for malignant, benign or unspecified conditions.

Documentation & 401.x 4th Digit

Be it malignant (.0), benign (.1), or unspecified (.9), while reporting codes from 401.x, you must select a fourth digit to complete the code. You shouldn't use either 0 malignant or .1 benign unless medical record documentation supports such a designation.

'Hypertensive' aids 402.x Use

If a patient has both heart disease and HTN, knowing whether the HTN caused the heart condition is key to correct coding. See whether the patient has a condition described under heart disease codes 425.8, 429.0-429.3, 429.8, and 429.9. What's more, you should also check the documentation for a stated or implied causal relationship to HTN.

Think that HTN and chronic kidney disease are connected

ICD-9 codes presume a causal relationship between HTN and chronic kidney disease. If documentation shows a patient ahs HTN and a condition that falls under 585.x or 587, then you should report a code from 403.x even if there is no indication one lead to the other. You should also report the pertinent 585.x code to indicate the CKD stage.

Hypertensive Heart and CKD

A single code from 404.xx indicates the patient has both hypertensive heart disease and hypertensive CKD. You should once again assume a relationship between the HTN and CKD. When the patient suffers from hypertensive heart disease and CKD, you should select a code from 404.xx and not report 402.x (hypertensive heart disease) and 403.x (hypertensive CKD) together.

Head Diagnoses? Think 2 Codes

If the patient is diagnosed with hypertensive cerebrovascular disease, you should first go for the proper code from 430-438.x first and then report the proper hypertension code, 401.x-405.x.