ICD-9-CM changes that will affect internists
By Brett Baker
Q: What changes have been made to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes? When do I need to start using them?
A: The Centers for Medicare and Medicaid Services (CMS), formerly HCFA, and the National Center for Health Statistics released ICD-9-CM code changes that took effect Oct. 1, 2001. Medicare and many other payers give physicians a three-month "grace period" to begin implementing new codes, which means you need to begin using the new codes no later than Jan. 1, 2002. The changes most relevant to internists are noted below and appear in numerical order.
Diseases of the respiratory system
Code 464.0, "acute laryngitis," has been expanded to two new five-digit codes:
- 464.00—Acute laryngitis without mention of obstruction
- 464.01—Acute laryngitis with obstruction
Diseases of the digestive system
A new five-digit code has been added to code 530.1, "esophagitis":
- 530.12—Acute esophagitis
Code 564.0, "constipation," has been expanded to four new five-digit codes:
- 564.00—Constipation, unspecified
- 564.01—Slow transit constipation
- 564.02—Outlet dysfunction constipation
- 564.09—Other constipation
Skin and subcutaneous diseases
Code 692.7, "dermatitis due to solar radiation," has been expanded with the addition of two new five-digit codes:
- 692.76—Sunburn of second degree
- 692.77—Sunburn of third degree
The description for code 692.82, "dermatitis due to other radiation," has been expanded to include exposure from tanning beds.
Diseases of the musculoskeletal system and connective tissue
Code 733.9, "Other unspecified disorders of bone and cartilage," has been expanded with the addition of three new five-digit codes:
- 733.93—Stress fracture of tibia and fibula
- 733.94—Stress fracture of metatarsals
- 733.95—Stress fracture of other bone
Symptoms, signs, and ill-defined conditions
Code 793.8, "Non-specific abnormal finding on radiologic examination of the breast," has been replaced by three new five-digit codes:
- 793.80—Abnormal mammogram, unspecified
- 793.81—Mammographic microcalcification
- 793.89—Other abnormal findings on radiologic examination of the breast
Factors influencing health status and contact with health services
Code V10.5, "personal history of malignant neoplasm of the urinary organs," has been expanded with the addition of a new five-digit code:
- V10.53—Renal pelvis
Code V70.7 has been revised:
- V70.7—General medical examination; examination of participant in clinical trial
Because there are so few changes related to internal medicine, it shouldn't be difficult to incorporate them into your practice. Simply noting these changes in your current ICD-9-CM book may suffice.
If you need a comprehensive list or an updated version of ICD-9-CM, you can purchase it through the AMA ($69.95 for members, $79.95 for nonmembers) by calling 800-621-8335. ICD-9-CM 2002 is also available through other vendors.
Brett Baker is a third-party payment specialist in the College's Washington office. If you have a question about third-party payment or coding issues, contact him at 202-261-4533 or firstname.lastname@example.org.
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