American College of Physicians: Internal Medicine — Doctors for Adults ®

Advertisement

The new ICD-9 codes that every internist should know

From the September ACP Observer, copyright 2005 by the American College of Physicians.

By Kerry Hunt and Carol McKenzie

Q: What changes have been made to codes in the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)? And when do these changes take effect?

A: The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) released ICD-9-CM code changes that will take effect October 1, 2005. Because Medicare no longer gives physicians a three-month grace period to make these changes, physicians must begin using the new codes no later than that date.

The changes most relevant to internists are noted below and appear in numerical order.

Endocrine, nutritional, metabolic, immunity disorders

Code 276.5, "Volume Depletion," is rendered invalid by the introduction of three new five-digit codes:

  • 276.50: Volume depletion, unspecified
  • 276.51: Dehydration
  • 276.52: Hypovolemia

Code 278.0, "Obesity," is expanded with the introduction of a new five-digit code:

  • 278.02: Overweight

Diseases of the blood and blood-forming organs

Code 287.3, "Primary thrombocytopenia," is rendered invalid by the introduction of five new five-digit codes:

  • 287.30: Primary thrombocytopenia, unspecified
  • 287.31: Immune thrombocytopenic purpura
  • 287.32: Evans' syndrome
  • 287.33: Congenital and hereditary thrombocytopenic purpura
  • 287.39: Other primary thrombocytopenia

Diseases of the nervous system and sense organs

A new code series (327), which pertains to sleep disorders, was added to the "Nervous System and Sense Organs" section of ICD-9. For a comprehensive listing of these new codes, see the "New Diagnosis Codes" table available on the CMS Web site.

Code 362.0, "Diabetic retinopathy," is expanded with the introduction of four new five-digit codes:

  • 362.03: Nonproliferative diabetic retinopathy NOS
  • 362.04: Mild nonproliferative diabetic retinopathy
  • 362.05: Moderate nonproliferative diabetic retinopathy
  • 362.06: Severe nonproliferative diabetic retinopathy

Diseases of the circulatory system

Code 426.8, "Other specified conduction disorders," is expanded with the introduction of a new five-digit code:

  • 426.82: Long QT syndrome

Diseases of the digestive system

Code 567, "Peritonitis," is expanded with the introduction of a new five-digit code:

  • 567.23: Spontaneous bacterial peritonitis

Diseases of the genitourinary system

Code 585, "Chronic renal failure," is rendered invalid by the introduction of seven new four-digit codes:

  • 585.1: Chronic kidney disease, Stage I
  • 585.2: Chronic kidney disease, Stage II (mild)
  • 585.3: Chronic kidney disease, Stage III (moderate)
  • 585.4: Chronic kidney disease, Stage IV (severe)
  • 585.5: Chronic kidney disease, Stage V
  • 585.6: End stage renal disease
  • 585.9: Chronic kidney disease, unspecified

Code 599.6, "Urinary obstruction, unspecified," is rendered invalid by the introduction of two new five-digit codes:

  • 599.60: Urinary obstruction, unspecified
  • 599.69: Urinary obstruction, not classified elsewhere

Symptoms, signs and ill-defined conditions

Code 799.0, "Asphyxia," is rendered invalid by the introduction of two new five-digit codes:

  • 799.01: Asphyxia
  • 799.02: Hypoxemia

Injury and poisoning

Code 996.4, "Mechanical complication of internal orthopedic device, implant, and graft" is rendered invalid by the introduction of nine new five-digit codes, one of which is:

  • 996.41: Mechanical loosening of prosthetic joint

Q: Are there any changes to ICD-9-CM code titles?

A: Yes. The CMS and the NCHS revised some of the diagnosis code titles, meaning that they changed the code descriptor language without altering how that language is to be used.

The following codes have revised diagnosis code titles, effective Oct. 1, 2005:

  • 285.2: Anemia in chronic kidney disease
  • 403.00: Hypertensive kidney disease, malignant, without chronic kidney disease
  • 403.01: Hypertensive kidney disease, malignant, with chronic kidney disease
  • 403.10: Hypertensive kidney disease, benign, without chronic kidney disease
  • 403.11: Hypertensive kidney disease, benign, with chronic kidney disease
  • 403.90: Hypertensive kidney disease, unspecified, without chronic kidney disease
  • 403.91: Hypertensive kidney disease, unspecified, with chronic kidney disease
  • 404.00: Hypertensive heart and kidney disease, malignant, without heart failure or chronic kidney disease
  • 404.01: Hypertensive heart and kidney disease, malignant, with heart failure
  • 404.02: Hypertensive heart and kidney disease, malignant, with chronic kidney disease
  • 404.03: Hypertensive heart and kidney disease, malignant, with heart failure and chronic kidney disease
  • 404.10: Hypertensive heart and kidney disease, benign, without heart failure or chronic kidney disease
  • 404.11: Hypertensive heart and kidney disease, benign, with heart failure
  • 404.12: Hypertensive heart and kidney disease, benign, with chronic kidney disease
  • 404.13: Hypertensive heart and kidney disease, benign, with heart failure and chronic kidney disease
  • 404.90: Hypertensive heart and kidney disease, unspecified, without heart failure or chronic kidney disease
  • 404.91: Hypertensive heart and kidney disease, unspecified, with heart failure
  • 404.92: Hypertensive heart and kidney disease, unspecified, with chronic kidney disease
  • 404.93: Hypertensive heart and kidney disease, unspecified, with heart failure and chronic kidney disease
  • 728.87: Muscle weakness (generalized)
  • 780.51: Insomnia with sleep apnea, unspecified
  • 780.52: Insomnia, unspecified
  • 780.53: Hypersomnia with sleep apnea, unspecified
  • 780.57: Unspecified sleep apnea

Kerry Hunt is a Senior Analyst in ACP's Washington office, while Carol McKenzie is Administrative Coordinator for Regulatory and Insurer Affairs and the Practice Management Center, also in ACP's Washington office.

You also can access a comprehensive list of the ICD-9-CM changes taking effect on Oct. 1, 2005 through the CMS Web site. Also see "New V codes internists need to know" and "Oct. 1 deadline for HIPAA-compliant claims."

ACP's Practice Management Center will update its "Commonly Used ICD-9" reference sheet by the time the changes take effect on Oct. 1, 2005. ACP members can access the card in Microsoft Word and PDA format online. A laminated version of the card is available through ACP Customer Service by calling 800-523-1546, ext. 2600.

Top


New V codes internists need to know

The Centers for Medicare and Medicaid Services and the National Center for Health Statistics released ICD-9-CM code changes that will take effect Oct. 1, 2005. Also changing effective Oct. 1 are V codes for supplementary classification of factors affecting health status.

Code V12.4, "Disorders of nervous system and sense organs," is expanded with the introduction of a new five-digit code:

  • V12.42: Personal history, Infections of the central nervous system

Code V12.6, "Diseases of the respiratory system," is rendered invalid by the introduction of three new five-digit codes:

  • V12.60: Personal history, Unspecified disease of respiratory system
  • V12.61: Personal history, Pneumonia (recurrent)
  • V12.69: Personal history, Other diseases of respiratory system

Code V13, "Personal history of other diseases," is expanded with the introduction of three new five-digit codes:

  • V13.02: Personal history, Urinary (tract) infection
  • V13.03: Personal history, Nephrotic syndrome
  • V15.88: History of fall

Code V17.8, "Other musculoskeletal diseases," is rendered invalid by the introduction of two new five-digit codes:

  • V17.81: Family history, Osteoporosis
  • V17.89: Family history, Other musculoskeletal diseases

Code V18, "Family history of certain other specific conditions," is expanded with the introduction of a new four-digit code:

  • V18.9: Family history, Genetic disease carrier

Code V26.3, "Genetic counseling and testing," is rendered invalid by the introduction of three new five-digit codes:

  • V26.31: Testing for genetic disease carrier status
  • V26.32: Other genetic testing
  • V26.33: Genetic counseling

Code V46.1, "Other dependence on machines," is expanded with the introduction of three new five-digit codes:

  • V46.13: Encounter for weaning from respirator [ventilator]
  • V46.14: Mechanical complication of respirator [ventilator]
  • V49.84: Bed confinement status

Code V58.1, "Chemotherapy," is rendered invalid by the introduction of two new five-digit codes:

  • V58.11: Encounter for antineoplastic chemotherapy
  • V58.12: Encounter for immunotherapy for neoplastic condition

Code V64.0, "Vaccination not carried out because of contradiction," is rendered invalid by the introduction of 10 new five-digit codes:

  • V64.00: Vaccination not carried out, unspecified reason
  • V64.01: Vaccination not carried out because of acute illness
  • V64.02: Vaccination not carried out because of chronic illness or condition
  • V64.03: Vaccination not carried out because of immune compromised state
  • V64.04: Vaccination not carried out because of allergy to vaccine or component
  • V64.05: Vaccination not carried out because of caregiver refusal
  • V64.06: Vaccination not carried out because of patient refusal
  • V64.07: Vaccination not carried out for religious reasons
  • V64.08: Vaccination not carried out because patient had dise
  • ase being vaccinated against
  • V64.09: Vaccination not carried out for other reason

Code V72.4, "Pregnancy examination or test," is expanded with the introduction of a new five-digit code:

  • V72.42 Pregnancy examination or test, positive result

A new code series (V85) pertaining to Body Mass Index has been added:

  • V85.0 Body Mass Index less than 19, adult
  • V85.1 Body Mass Index between 19-24, adult
  • V85.21 Body Mass Index 25.0-25.9, adult
  • V85.22 Body Mass Index 26.0-26.9, adult
  • V85.23 Body Mass Index 27.0-27.9, adult
  • V85.24 Body Mass Index 28.0-28.9, adult
  • V85.25 Body Mass Index 29.0-29.9, adult
  • V85.30 Body Mass Index 30.0-30.9, adult
  • V85.31 Body Mass Index 31.0-31.9, adult
  • V85.32 Body Mass Index 32.0-32.9, adult
  • V85.33 Body Mass Index 33.0-33.9, adult
  • V85.34 Body Mass Index 34.0-34.9, adult
  • V85.35 Body Mass Index 35.0-35.9, adult
  • V85.36 Body Mass Index 36.0-36.9, adult
  • V85.37 Body Mass Index 37.0-37.9, adult
  • V85.38 Body Mass Index 38.0-38.9, adult
  • V85.39 Body Mass Index 39.0-39.9, adult
  • V85.4 Body Mass Index 40 and over, adult

Top


Oct. 1 deadline for HIPAA-compliant claims

The Centers for Medicare and Medicaid Services will no longer process non-HIPAA compliant electronic Medicare claims after Oct. 1, 2005.

As of that date, fee-for-service claims failing to meet HIPAA standards will be returned to be resubmitted as compliant claims. The move will end a portion of the agency's HIPAA contingency plan announced in October 2003, which extended the compliance deadline.

More information is on the CMS Web site.

Top

This is a printer-friendly version of this page

Print this page  |  Close the preview

Share

 
 

Internist Archives Quick Links

ACP Clinical Shorts

Expert Education on Your Schedule

Short videos deliver highly focused answers to challenging clinical situations seen in practice and are a terrific way to earn CME credit on-the-goShort videos deliver highly focused answers to challenging clinical situations seen in practice and are a terrific way to earn CME credit on-the-go. See more.

New: Free Modules from ACP Practice Advisor!

New: Free Modules from ACP Practice Advisor!

Keep your practice moving in the right direction. ACP Practice Advisor is offering four modules that you and your staff can try for free. Get to know the premier online practice management tool at no risk. Explore the modules.