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Your PracticeThe new ICD-9 codes that will affect internists

From the November 2000 ACP-ASIM Observer, copyright © 2000 by the American College of Physicians-American Society of Internal Medicine.

By Brett Baker

Q:

Have there been any changes to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes? If so, when must I start using the new codes?

A:

HCFA and the National Center for Health Statistics released ICD-9 code changes that took effect Oct. 1, 2000. Payers typically give physicians a three-month "grace period," so you should begin using the new codes by Jan. 1, 2001, at the latest. The changes that are most relevant to internists are listed below:

Respiratory system diseases
Code 494, "Bronchiectasis," has been replaced by two new four-digit codes:

  • 494.0—Bronchiectasis without acute exacerbation
  • 494.1—Bronchiectasis with acute exacerbation

Genitourinary system diseases
Code 596.5, "Other functional disorders of the bladder," has been replaced by a new five-digit code:

  • 596.51—Hypertonicity of bladder

Code 600, "Hyperplasia of prostate," has been expanded into new four-digit codes:

  • 600.0—Hypertrophy (benign) of prostate
  • 600.1—Nodular prostate
  • 600.2—Benign localized hyperplasia of prostate
  • 600.3—Cyst of prostate
  • 600.9—Hyperplasia of prostate, unspecified

Musculoskeletal system and connective tissue diseases
Code 707.1, "Ulcer of lower limb, except decubitus," has been expanded into new five-digit codes:

  • 707.10—Ulcer of lower limb, unspecified
  • 707.11—Ulcer of thigh
  • 707.12—Ulcer of calf
  • 707.13—Ulcer of ankle
  • 707.14—Ulcer of heel, mid-foot
  • 707.15—Ulcer of other part of foot
  • 707.19—Ulcer of other part of lower limbs

Signs, symptoms and ill-defined conditions
ACP-ASIM Observer, November 2000 -Code 781.9, "Other symptoms involving nervous and musculoskeletal system," has been replaced by new five-digit codes:

  • 781.91—Loss of height
  • 781.92—Abnormal posture
  • 781.99—Other symptoms involving nervous and musculoskeletal systems

Code 783.2, "Abnormal loss of weight," has been replaced by two new five-digit codes:

  • 783.21—Weight loss, abnormal
  • 783.22—Underweight

For "Failure to thrive" in adults, code 783.4 no longer applies. The new code is:

  • 783.7—Adult failure to thrive

Factors influencing health status and contact with health services
Code V15.0, "Personal history of allergy, other than medicinal agents," has been replaced by new five-digit codes:

  • V15.01—Allergy to peanuts
  • V15.02—Allergy to milk products
  • V15.03—Allergy to eggs
  • V15.04—Allergy to seafood
  • V15.05—Allergy to other foods
  • V15.06—Allergy to insects
  • V15.07—Allergy to latex
  • V15.08—Allergy to radiographic dye
  • V15.09—Other allergy, other than to medicinal agents

The code V67.0, "Follow-up examination after surgery," has been replaced by new five-digit codes:

  • V67.00—Following surgery, unspecified
  • V67.01—Follow-up vaginal pap smear
  • Vaginal pap smear status-post hysterectomy for malignant condition (use V76.47 for vaginal pap smear status-post hysterectomy for non-malignant condition)
  • V67.09—Following other surgery

The modest number of changes related to internal medicine should ease the burden of incorporating them into your practice. Simply noting these changes in your current edition of ICD-9-CM may suffice.

If you need a comprehensive list or an updated version of ICD-9-CM, you can purchase the AMA's ICD-9-CM 2001 ($61.95 for AMA members, $71.95 for nonmembers) by calling 800-621-8335.

College members can also get a list of the ICD-9 codes commonly used by internists from the Center for a Competitive Advantage. The list is available on the Web at www.acponline.org/cca/ or through ACP­ASIM Customer Service at 800-523-1546, ext. 2600, or 215-351-2600 (9 a.m. to 5 p.m., EST). Ask for product number 410100381.

Brett Baker is a third-party payment specialist in the College's Washington Office. If you have questions on third-party payment or coding issues, contact him at 202-261-4533 or bbaker@acponline.org.

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