2008 ICD-9 Coding Changes
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1 Coding Update: New, Revised and Deleted Codes Effective October 1, 2007 Presented By: Melinda A. Gaboury, CEO Healthcare Provider Solutions, Inc ICD-9 Coding Changes The 2008 ICD-9 codes will be effective October 1, 2007 There is no grace period for the use of these codes This is for episodes that begin on or after the October 1, 2007 date 2008 ICD-9 Codes There are 142 New ICD-9 codes There are 17 Invalid ICD-9 codes There are 5 Revised ICD-9 Codes There are 2 New and 1 Invalid ICD-9 codes which were not included in the proposed rule, but WILL be effective on October 1,
2 2008 New ICD-9 Codes Of the NEW ICD-9 codes, 54 of them are for some type of Lymphoma They are found in the 200 ICD-9 category They are divided by cell type and location They will be 5 digit ICD-9 codes 2008 New ICD-9 Codes Marginal zone lymphoma Mantle cell lymphoma Primary central nervous system lymphoma Anaplastic large cell lymphoma Large cell lymphoma Peripheral T-cell lymphoma (Note: On New ICD-9 listing T-Cell is listed with repeated number of ) 2008 New ICD-9 Codes Unspecified Site, Extranodal and Solid Organ Sites 200.X0 Lymph nodes of head, face and neck 200.X1 Intrathoracic lymph nodes 200.X2 Intraabdominal lymph nodes 200.X3 Lymph nodes of axilla and upper limb 200.X4 Lymph nodes of inguinal region and lower limb 200.X5 Intrapelvic Lymph nodes 200.X6 Spleen 200.X7 Lymph nodes of multiple sites 200.X8 2
3 2008 New ICD-9 Codes Three additional Cancer ICD-9 codes: Carcinoma in situ, unspecified female genital organ Carcinoma in situ, vagina Carcinoma in situ, vulva 2008 New ICD-9 Codes Additional endocrine related ICD-9 codes: Glucocorticoid deficiency Mineralocorticoid deficiency Multiple endocrine neoplasia [MEN] type I Multiple endocrine neoplasia [MEN] type IIA Multiple endocrine neoplasia [MEN] type IIB 2008 New ICD-9 Codes New Blood Related ICD-9 codes: Red cell aplasia (acquired) (adult) (with thymoma) Other specified aplastic anemias Bandemia 3
4 2008 New ICD-9 Codes New Muscular and Neurological Related ICD-9 codes: Myotonic muscular dystrophy Myotonic chondrodystrophy Drug induced myotonia Other specified myotonic disorder 2008 New ICD-9 Codes New Cardiac and Pulmonary Related ICD-9 codes: Chronic total occlusion of coronary artery Septic pulmonary embolism Cardiac tamponade Chronic total occlusion of artery of the extremities 449 Septic arterial embolism 488 Influenza due to identified avian influenza virus 2008 New ICD-9 Codes Two ICD-9 codes which were not finalized in time for the proposed rule, but will be effective October 1, 2007: Infection due to central venous catheter Infection following other infusion, injection, transfusion, or vaccination 4
5 2008 New ICD-9 Codes ICD-9 codes which could affect speech-language pathology include: Speech and language development due to hearing loss Acquired auditory processing disorder Conductive hearing loss, unilateral Conductive hearing loss, bilateral Neural hearing loss, unilateral Sensory hearing loss, unilateral Mixed hearing loss, unspecified Mixed hearing loss, unilateral Mixed hearing loss, bilateral 2008 New ICD-9 Codes ICD-9 codes which could affect speechlanguage pathology include the new specific Dysphagia category: Dysphagia, unspecified Dysphagia, oral phase Dysphagia, oropharyngeal phase Dysphagia, pharyngeal phase Dysphagia, pharyngoesophageal phase Other dysphagia 2008 New ICD-9 Codes Additional New ICD-9 codes include various other issues including: Dental issues Female genitalia Childhood development issues Ascites Anal sphincter 5
6 2008 New ICD-9 Codes New V-Codes include several history codes for both personal and family histories Disability examination Dual sensory impairment Procreative management and fertility Genetic susceptibility Special Screenings 2008 Invalid ICD-9 Codes Carcinoma in situ, other and unspecified female genital organs Corticoadrenal insufficiency Polyglandular activity in multiple endocrine adenomatosis Other specified aplastic anemias Myotonic Disorders Other disorders of iris and ciliary body Mixed conductive and sensourinal hearing loss Dystrophy of vulva Dysphagia Ascites Complications of medical care, not elsewhere classified, Other infection 2008 Invalid ICD-9 Codes V17.4 Family history of other cardiovascular diseases V18.1 Family history of other endocrine and metabolic diseases V26.4 Procreative management, general counseling and advice V26.8 Other specified procreative management V68.0 Issue of medical certificates V84.8 Genetic susceptibility to other disease These codes are all invalid due to the fact that they have either been expanded on, a new category has been created, or they have been incorporated elsewhere 6
7 2008 Revised ICD-9 Codes Botulism food poisoning Periodic paralysis Central hearing loss Sensorineural hearing loss, bilateral Deaf, nonspeaking, not elsewhere classified These codes are all revised due to the fact that either new categories were created or the ICD-9 code was expanded to become more specific ICD-9 Codes To obtain a copy of these changes, link to: agnosticcodes/07_summarytables.asp #TopOfPage OASIS Coding When V-Code is used at M0230 where a Case Mix Diagnosis is currently being used you will need to put Case Mix Diagnosis in M M0246 in 2008 Use of M0245/M0246 is OPTIONAL!! 7
8 New OASIS Item: M0245 OASIS Coding This item allows the use of V-codes in the diagnosis code M0 items M0230 & M0240 The only time there will be a code in M0245a and M0245b is when the V code in M0230 replaces a 2-part manifestation code M0246 (use in 2008) This item allows the use of V-codes in the diagnosis code M0 items M0230 & M0240 opportunity to report code that V-code replaced on each line OASIS Coding (M0230) Primary Diagnosis & (M0240) Other Diagnoses (M0246) Case Mix Diagnoses (OPTIONAL) (1) (2) (3) (4) Complete only if the V code in Colum n 2 is reported in Complete only if a V code in place of a case mix ICD-9-CM and severity Column 2 is reported in diagnosis that is a multiple rating for each condition place of a case mix coding situation (e.g., a diagnosis. manifestation code). ICD-9-CM / Description/ Description/ Description Severity Rating ICD-9-CM ICD-9-CM (M0230) Primary Diagnosis (V codes are allowed) (V or E codes NOT allowed) (V or E codes NOT allowed) a. ( ) a. a ( ) ( ) (M0240) Other Diagnoses (V or E codes are allowed) (V or E codes NOT allowed) (V or E codes NOT allowed) b. ( ) b. b ( ) ( ) c. ( ) c. c ( ) ( ) d. ( ) d. d ( ) ( ) e. ( ) e. e ( ) ( ) f. ( ) f. f ( ) ( ) General Coding Principles Coding for Home Health May or may not relate to recent hospital stay Must relate to services rendered by the HHA If more than one diagnosis is being treated concurrently the one that represents the most acute condition & requires most intensive services is the one that should be entered 8
9 General Coding Principles Include not only conditions that are actively addressed in the POC, but also comorbidities affecting the patient s responsiveness to treatment Avoid listing diagnoses that are of mere historical interest & without impact on patient progress or outcome Expanded Diagnosis Categories Stroke * Neurological brain & peripheral * Multiple Sclerosis * Hypertension Gait disorders * Heart disease Blindness Diabetes Skin Dysphagia* Gastrointestinal Pulmonary Cancer Orthopedic * Blood disorders Psychoses & affective disorders *codes that require additional criteria 9
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