ICD-9: What's changed

New ICD-9-CM diagnosis codes took effect Oct 1. If you haven't already, you need to review the new codes and update your encounter forms and charge tickets because any claims using outdated codes will be rejected. Remember that CMS no longer grants a 90-day grace period for billing discontinued diagnosis codes.

There are 173 new codes, 53 of them V codes. Also, 28 codes have been revised and 14 have been deleted completely.

The majority of the new codes have fifth digits, making them more specific. To avoid rejected claims, you must make a conscious effort to use the codes (backed up by more-specific documentation), especially when submitting Medicare claims, says Maxine Lewis of Medical Coding Reimbursement Management in Cincinnati.

The new ICD-9-CM update also includes new V64.0x codes that allow you to specify why a patient didn't receive a vaccination. These 10 new codes will allow your office to better track immunizations, highlighting patients whose vaccinations were missed or delayed, says Lewis.

Other new codes allow you to describe sleep and breathing disorders more specifically. You'll use the series 327.xx, which goes into detail about types and causes of insomnia, hypersomnia, sleep apnea, and other breathing problems.

Review the following new, revised, and deleted codes to see how they impact your practice.

New diagnosis codes

Endocrine, nutritional, and metabolic diseases and immunity disorders

259.5 Androgen insensitivity syndrome
276.50 Volume depletion, unspecified
276.51 Dehydration
276.52 Hypovolemia
278.02 Overweight

Diseases of the blood and blood-forming organs

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

Mental disorders

291.82 Alcohol induced sleep disorders
292.85 Drug induced sleep disorders