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Follow these steps when researching an ICD-9-CM coding question:
- Start with the ICD-9-CM Manual. You can resolve many ICD-9-CM coding questions by carefully studying the ICD-9-CM Manual itself, paying particular attention to typographical conventions and the various notes included throughout the Manual.
- Review the official guidelines. The Public Health Service and CMS jointly publish the Official ICD-9-CM Guidelines for Coding and Reporting. The following organizations helped develop and approve these guidelines:
- American Hospital Association (AHA)
- AHIMA
- CMS
- National Center for Health Statistics
- Review Coding Clinic. Coding Clinic is a newsletter published by the AHA. Representatives from the four organizations listed above review and approve each issue of Coding Clinic. You can order a subscription or back issues of Coding Clinic from the AHA by calling 800/AHA-2626.
This tip was adapted from the handbook, Coding and You: What Every Healthcare Professional Should Know. For ordering information, visit the HCMarketplace.
Q: A patient undergoes outpatient surgery and is subsequently admitted due to acute blood loss anemia with hemorrhage and low hematocrit and hemoglobin caused by Plavix®. A physician had instructed the patient to discontinue this medication 10 days before surgery. However, the patient admits after surgery that he or she stopped taking the drug only two days before surgery.
What ICD-9 code(s) should I report for this scenario? Read More→
July 20-27 Issuances: CMS posts NCD, OIG issues reports, ICD-9-CM errata available
CMS posts NCD for sleep testing for obstructive sleep apnea (OSA)
On July 21, CMS posted an NCD for sleep testing for OSA.
OIG issues audit reports on Epogen
The OIG released several audit reports on Epogen payments to various facilities of Fresenius Medical Care. The OIG found that claims errors occurred because staff responsible for documenting and flagging the patients’ files for changes in ordered Epogen amounts did not always follow the policy and procedures in the Fresenius Manual for ensuring that changes in the units of Epogen ordered were properly identified and entered into the Fresenius System. The OIG determined that these errors resulted in overpayments.
ICD-9-CM errata
The errata to the ICD-9-CM index and tabular addenda are now available.
Frequently asked questions
CMS posted several new/updated FAQs.
Join MedicareFind today for a direct link to this and all the documents in our regulatory database.
Despite the fact that ICD-10 implementation is still nearly three years away, CMS is ramping up its educational resources now to equip providers with the necessary tools to begin the transition. The next 36 months will pass by quickly, says Sue Bowman, RHIA, CCS, director of coding policy and compliance at the American Health Information Management Association (AHIMA) in Chicago.
"The reason [CMS] picked 2013 [as its implementation date] instead of the original 2011 is that the commenters said they needed that long to make the conversion," Bowman says. "If you need that long, you need to start today. It’s less expensive to spread it out and do it in a strategic fashion."
CMS and the Centers for Disease Control and Prevention wanted to help providers take the first step toward implementation. These agencies, along with AHIMA and the American Hospital Association, created General Equivalence Mappings (GEM), a bidirectional tool to aid providers in the switch from ICD-9 to ICD-10. GEM demonstrates how a code in one set (i.e., the source system) translates to the other (i.e., the target system), with conversions based on code book instructions, index entries, and Coding Clinic advice.
Editor’s note: To learn more about the GEMs or to purchase a copy of this article for $10, visit the HCPro Web site. Subscribers to Briefings on Coding Compliance Strategies have access to this article in the July issue of the newsletter.
CMS implements FDG PET NCD
On July 17, CMS issued two transmittals to implement its recent NCD for FDG PET for solid tumors and myeloma. CMS is adopting a coverage framework that replaces the four-part diagnosis, staging, restaging and monitoring response to treatment categories with a two-part framework that differentiates FDG PET imaging used to inform the initial antitumor treatment strategy from other uses related to guiding subsequent antitumor treatment strategies after the completion of initial treatment.
Effective date: April 6, 2009
Implementation date: August 17, 2009 for local edits; OCTOBER 5, 2009, for FISS and CWF edits
MLN Matters article
CMS released an MLN Matters article related to a transmittal previously outlined in Medicare Weekly Update: Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
Join MedicareFind today for a direct link to this and all the documents in our regulatory database.
ICD-9-CM October 2009 update available
The fiscal year 2010 ICD-9-CM index to diseases addenda, tabular addenda, and new code conversion table are now available. These are effective October 1, 2009.
View the ICD-9-CM index to diseases addenda.
View the ICD-9-CM tabular addenda.
View the ICD-9-CM new code conversion table.
Frequently asked questions
CMS issued several new/updated frequently asked questions (FAQ) last week.
On June 3, the National Center for Health Statistics (NCHS) posted its ICD-9-CM index addenda and ICD-9-CM tabular addenda. As part of the 2010 addenda, NCHS has expanded code category 488 to add two new codes:
- 488.0 (Influenza due to identified avian influenza virus)
- 488.1 (Influenza due to identified novel H1N1 influenza virus)
In addition, coders and others can reference an ICD-9-CM code conversion table at www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/icdcnv10.pdf.
On June 10, CMS posted the new, revised, and invalid diagnosis and procedure codes on its Web site.
Each of these changes, many of which pertain to new E codes, will take effect October 1.
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