What versions of the ICD are currently in use?

ICD-10, the most recent iteration of the coding system, is used throughout the world; more than 100 countries use it for reporting deaths, and about two dozen also use ICD-10 codes for reimbursement and resource allocation. Its earliest adopters include the Nordic countries, which began a four-year ICD-10 implementation in 1994, and the United Kingdom, which began using the standard in 1995. ICD-10 contains 22 chapters, each of which defines a different set of conditions or diseases.

Providers in the United States use ICD-10 to report mortality data, but still use ICD-9-CM to report morbidity data and to complete Medicare and Medicaid claims. Neither ICD-10-CM nor ICD-10-PCS is currently in use, nor will they be used before Oct. 1, 2014.

Not surprisingly, ICD-9 is outdated. According to the CMS history of ICD-9-CM, the existing standard is rigid, inexact and not descriptive enough, in addition to being obsolete. For example, codes for a combination defibrillator-pacemaker device do not appear in the cardiovascular chapter of ICD-9-CM, which includes codes for defibrillator and pacemaker devices separately. In addition, as the American Medical Association (AMA) pointed out, chapters pertaining to complex body systems filled quickly, meaning that new codes for cardiac systems were assigned to the chapter initially reserved for the eye.

Billing for No-Shows? Here are Some Best Practices to Get Deserved Pay

Patients missing appointments?  Implement a no-show policy to keep your income steady despite missed appointments!

Missed appointments have an impact on your physician’s schedule or his availability to other patients, and can also pose a health threat to the patient. Here are some no-show best practices to ensure your practice is maximizing your physician’s time, and getting the reimbursements it deserves.

Choose Between 782.9 and 705.89 for Body Odor

Question: A mother brought her 6-year-old daughter to our office because she was concerned about the daughter's body odor. She follows good hygiene. The physician assistant thought it might be thyroid related so wants to send the child for lab work. What diagnosis should we report?

CD-9 2007 Update: Using 997.99 to Report Bleb Infection?

New diagnosis codes include stages of post-trabeculectomy inflammations -- and a new code for ONH 

When a patient presents with a post-op bleb infection, the current ICD-9 index guides you to 997.99 (Complications affecting other specified body systems, not elsewhere classified; other). Starting in October, however, you’ll be able to code the condition -- and the level of severity  -- much more precisely.

Medicare has released 204 new ICD codes that should appear in your 2007 ICD-9 coding manual. Among them are four new blebitis codes that the American Academy of Ophthalmology asked for at the ICD-9 CM Coordination and Maintenance Committee meeting in September 2005.

NCCI 11.3 Update: Include Duct Probe in Dacryocystorhinostomy

The latest bundles also clarify the rules for IOL exchanges
You probably won’t tear up when you see what NCCI is up to this quarter--unless your practice spends a fair share of its time performing nasolacrimal probes.

NCCI version 11.3, that took effect Oct. 1, specifies that CPT codes 68810 (Probing of nasolacrimal duct, with or without irrigation) and 68811 (… requiring general anesthesia) are included in:

• 31239--Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy

• 68530--Removal of foreign body or dacryolith, lacrimal passages

• 68720--Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity).

What HCPC code to use for just injection Lidocaine

A quick glance might make you think J2001 (Injection, Lidocaine HCl for intravenous infusion 10 mg) might be a possibility, but don't go that route. Code J2001 represents IV infusion of Lidocaine, which is used for cardiac arrhythmias and not as a local anesthetic. A better choice might be J3490 (Unclassified drugs) with a note in Box 19 to indicate the drug and its concentration.

Caution: Many payers do not allow separate reimbursement for local aesthetic ,as they consider it to be part of the injection procedure." 

Partial vs. Total Ethmoidectomy

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.


Question: How would you code a right-side nasal sinus endoscopy with total ethmoidectomy, plus a left-side endoscopy with partial ethmoidectomy?