Healthcare News: CMS posts 2010 ICD-9 code update to take effect October 1

On June 10, CMS posted the new, revised, and invalid diagnosis and procedure codes on its Web site.

Among the changes, there are a significant number of new E codes, including a new section titled “External cause status (E000)”. Guidance for this new section states:

A code from category E000 should be used in conjunction with the external cause code(s) assigned to a record to indicate the status of the person at the time the event occurred. A single code from category E000 should be assigned for an encounter.

There is also a new section titled “Activity (E001–E030),” which states:

Categories E001 to E030 are provided for use to indicate the activity of the person seeking healthcare for an injury or health condition, such as a heart attack while shoveling snow, which resulted from, or was contributed to, by the activity. These codes are appropriate for use for both acute injuries, such as those from chapter 17, and conditions that are due to the long-term, cumulative effects of an activity, such as those from chapter 13. They are also appropriate for use with external cause codes for cause and intent if identifying the activity provides additional information on the event.

These codes should be used in conjunction with other external cause codes for external cause status (E000) and place of occurrence (E849).

In addition, differentiation is made between patients with chronic versus acute venous embolisms/thrombosis for both lower and upper extremities. The new series of codes (453.5x–453.8x) also identify specific vessels in the upper extremities (e.g., axillary, subclavian). All of these added codes are considered complication and comorbidity (CC) conditions.  

CMS will require a fifth digit for code 768.7 to identify the varying degrees of hypoxic-ischemic encephalopathy in newborns. New codes identify:

• Unspecified (768.70)
• Mild, moderate (768.71)
• Severe (768.72)

The unspecified and mild and moderate codes are identified as CC conditions, whereas the code for severe hypoxic-ischemic encephalopathy is a major CC (MCC) condition.  

“This addition may present opportunities for obtaining the most specific information [even though the MS-DRGS for newborns are not necessarily CC/MCC driven],” says Shannon E. McCall, RHIA, CCS, CCS-P, CPC, director of coding and HIM at HCPro, Inc., in Marblehead, MA. “We’ll have to await the final rule to see whether these are considered ‘major’ or ‘significant’ problems for MS-DRG assignment.”

Interested in learning more about the 2010 ICD-9-CM codes? Robert S. Gold, MD, and Gloryanne Bryant, BS, RHIA, RHIT, CCS, will discuss the code changes and what you need to know and do to implement them into your current system during an August 26 HCPro audio conference, “The Impact of the New and Revised 2010 ICD-9-CM Codes”. Details about this presentation and how to register for this audio conference will be posted soon on the HCMarketplace Web site.