ICD-9-CM Expert. for Payers Volumes 1, 2 & 3. International Classification of Diseases 9th Revision Clinical Modification.

Transcription

1 ICD-9-CM Expert for Payers Volumes 1, 2 & 3 International Classification of Diseases 9th Revision Clinical Modification Sixth Edition Edited by: Anita C. Hart, RHIA, S, S-P Catherine A. Hopkins Beth Ford, RHIT, S Ingenix is committed to providing you with the ICD-9-CM code update information you need to code accurately and to be in compliance with HIPAA regulations. In the case of adoption of additional ICD-9-CM code changes effective April 1, 2006, Ingenix will provide these code changes to you at no additional cost! Just check back at and look for the ICD-9-CM Update icon to review the latest information concerning any new code changes. Codes Valid October 1, 2005, through September 30, 2006

2 Tabular List CIRCULATORY SYSTEM Nerve Conduction of the Heart < >Cardiomyopathy in other diseases classified >elsewhere Code first underlying disease, as: Friedreich s ataxia (334.0) myotonia atrophica (359.2) progressive muscular dystrophy (359.1) sarcoidosis (135) E X C L U D E S cardiomyopathy in Chagas disease (086.0) Excl: See code AHA: 2Q, 93, Secondary cardiomyopathy, unspecified Excl: See code ' 426 Conduction disorders DEF: Disruption or disturbance in the electrical impulses that regulate heartbeats Atrioventricular block, complete Third degree atrioventricular block Excl: , , , , k Atrioventricular block, other and unspecified Atrioventricular block, unspecified Atrioventricular [AV] block (incomplete) (partial) First degree atrioventricular block Incomplete atrioventricular block, first degree Prolonged P-R interval Mobitz (type) II atrioventricular block Incomplete atrioventricular block: Mobitz (type) II second degree, Mobitz (type) II Excl: See code DEF: Impaired conduction of excitatory impulse from cardiac atrium to ventricle through AV node Other second degree atrioventricular block Incomplete atrioventricular block: Mobitz (type) I [Wenckebach s] second degree: Mobitz (type) I with 2:1 atrioventricular response [block] Wenckebach s phenomenon Excl: See code DEF: Wenckebach s phenomenon: impulses generated at constant rate to sinus node, P-R interval lengthens; results in cycle of ventricular inadequacy and shortened P-R interval; second-degree A-V block commonly called "Mobitz type < >Left bundle branch hemiblock Block: left anterior fascicular left posterior fascicular CD CD >Other left bundle branch block Left bundle branch block: anterior fascicular with posterior fascicular complete main stem >Right bundle branch block AHA: 3Q, 00, 3 k Bundle branch block, other and unspecified < >Bundle branch block, unspecified Right bundle branch block and left posterior fascicular block Right bundle branch block and left anterior fascicular block Other bilateral bundle branch block Bifascicular block Bilateral bundle branch block Right bundle branch with left bundle branch block (incomplete) (main stem) Excl: See code Trifascicular block Excl: See code Other heart block Intraventricular block: Sinoatrial block Sinoauricular block diffuse myofibrillar Excl: See code Anomalous atrioventricular excitation Atrioventricular conduction: accelerated accessory pre-excitation Ventricular pre-excitation Wolff-Parkinson-White syndrome Excl: See code DEF: Wolff-Parkinson-White: normal conduction pathway is bypassed; results in short P-R interval on EKG; tendency to supraventricular tachycardia. k Other specified conduction disorders Lown-Ganong-Levine syndrome Syndrome of short P-R interval, normal QRS complexes, and supraventricular tachycardias Excl: See code Long QT syndrome AHA: w4q, 05, 72x DEF: Condition characterized by recurrent syncope, malignant arrhythmias, and sudden death; characteristic prolonged Q-T interval on electrocardiogram Other Dissociation: atrioventricular [AV] interference isorhythmic Nonparoxysmal AV nodal tachycardia Excl: See code Conduction disorder, unspecified Heart block Stokes-Adams syndrome Excl: See code ' 427 Cardiac dysrhythmias E X C L U D E S that complicating: abortion ( with.7, 639.8) ectopic or molar pregnancy (639.8) labor or delivery (668.1, 669.4) AHA: J-A, 85, 15 DEF: Disruption or disturbance in the rhythm of heartbeats. ' Additional Digit Required k Nonspecific PDx Unacceptable PDx Manifestation Code MSP Medicare Secondary Payer wx Revised Text l New Code s Revised Code Title

3 Tabular List OPERATIONS ON THE CARDIOVASCULAR SYSTEM ' Additional Digit Required >Implantation of cardiomyostimulation >system Note: Two-step open procedure consisting of tranfer of one end of the latissimus dorsi muscle; wrapping it around the heart; rib resection; implantation of epicardial cardiac pacing leads into the right ventricle; tunneling and pocket creation for the cardiomyostimulator. AHA: 4Q, 98, 75; 1Q, 98, < >Insertion of percutaneous external heart >assist device Circulatory assist device Extrinsic heart assist device pvad Percutaneous heart assist device I N C L U D E S percutaneous [femoral] insertion of cannulae attachments s ' 37.7 Insertion, revision, replacement, and removal of pacemaker leads; insertion of temporary pacemaker system; or revision of cardiac device pocket Code also any insertion and replacement of pacemaker device ( ) E X C L U D E S implantation or replacement of transvenous lead [electrode] into left ventricular cardiac venous system (00.52) AHA: 1Q, 94, 16; 3Q, 92, 3; M-J, 87, 1 < > < >Initial insertion of lea< >d [electrode], not < >otherwise specified < >Initial insertion of transvenous lead < >[electrode] into ventricle < >Initial insertion of transvenous leads < >[electrodes] into atrium and ventricle AHA: 2Q, 97, < >Initial insertion of transvenous lead < >[electrode] into atrium < >Insertion or replacement of epicardial lead >[electrode] into epicardium Insertion or replacement of epicardial lead by: sternotomy E X C L U D E S thoracotomy >Revision of lead [electrode] Repair of electrode [removal with re - i n s e r t i o n ] Repositioning of lead [electrode] Revision of lead E X C L U D E S repositioning of temporary system omit code AHA: 2Q, 99, 11 Nonspecific OR Procedure Valid OR Procedure Non-OR Procedure Insertion of Pacemaker >Replacement of transvenous atrial and/or >ventricular lead(s) [electrode] Removal or abandonment of existing transvenous or epicardial lead(s) with transvenous lead(s) replacement E X C L U D E S replacement of epicardial lead [electrode] (37.74) >Removal of lead(s) [electrode] without >replacement Removal: epicardial lead (transthoracic approach) transvenous lead(s) E X C L U D E S removal of temporary transvenous pacemaker system omit code that with replacement of: atrial and/or ventricular lead(s) [electrode] (37.76) epicardial lead [electrode] (37.74) Insertion of temporary transvenous pacemaker system E X C L U D E S intraoperative cardiac pacemaker (39.64) AHA: 3Q, 93, 12; 1Q, 89, 2 s >Revision or relocation of cardiac device >pocket Debridement and reforming pocket (skin and subcutaneous tissue) Relocation of pocket [creation of new pocket] pacemaker or CRT-P wrevision or relocation of pacemaker, defibrillator, or other implanted cardiac device pocketx Left Atrial Appendage Device Insertion 10 Valid OR procedure code if accompanied by one of the following codes: 37.80, 37.81, 37.82, 37.85, 37.86, Valid OR procedure code if accompanied by one of the following codes: 37.80, Valid OR procedure code if accompanied by one of the following codes: 37.80, 37.85, 37.86, Valid OR procedure code if accompanied by one of the following codes: 37.80, 37.81, 37.82, 37.83, 37.85, 37.86, Adjunct Code

4 Resources

5 Home Health PPS Clinical Dimension Diagnosis List Home Health PPS Clinical Dimensions Group The home health resource group (HHRG) classification system includes the clinical dimensions case mix group. The data elements are organized into three dimensions; clinical, functional, and service utilization. The clinical dimension is defined by certain primary and secondary diagnosis codes as reported on the OASIS assessment instrument under data elements M0230 and M0240. Codes with four and five digits must be coded to that level on the OASIS assessment instrument. A list of those primary and secondary codes is provided in this resource. Refer to the Overview of the Home Health Agency Prospective Payment System resource in your code book for a more detailed discussion of the case mix classification system. Reminder: All codes designated with an asterisk (*) represent sequence or range of codes and any codes within that code category or subcategory are represented. All codes should be reported to the highest level of specificity. Codes indicated at the three and four digit levels include all related four and five digit codes. Diagnosis codes with four and five digits must be coded to that level on the OASIS assessment instrument. Orthopedic Primary Diagnoses *170 *171 * *274.1 * *710 *711.0 *711.9 *712.8 * * * *716.0 *716.1 *716.2 *716.3 *716.4 * *716.8 * * * *718.2 *718.3 *718.4 * *718.7 * * * * *722.7 *722.8 * * * * *728.7 * *730.0 *730.1 *730.2 *730.3 * *781.9 *800 *801 *802 *803 *804 *805 *806 *807 *808 *809 *810 *811 *812 *813 *814 *815 *816 *817 *818 *819 *820 *821 *822 *823 *824 *825 *827 *828 *831 *832 *833 *835 *836 *837 *838 *846 *847 *887 *896 *927 *928 Secondary Diagnoses *711.1 *711.2 *711.3 *711.4 *711.5 *711.6 *711.7 *711.8 *712.1 *712.2 * *730.7 * Neurology Primary Diagnoses *013 *045 *046 * *049 *191 *192 * * * *333