Welcome these new pneumonia, fluencey disorder, and cystostomy complication codes
The CMS has revealed the proposed changes to the hospital inpatient prospective payment systems (PPS), giving us the first glance at the ICD-9 changes for 2011. So what’s in store for home health coders?
Influenza with Pneumonia
Well, you will witness a beefed up 488.0x (Influenza due to identified avian influenza virus) and 488.1x (Influenza due to identified novel H1N1 influenza virus). The co-operating parties figured out that these sub categories did not provide the level of detail that category 487 (Influenza) does; as such they expanded the codes at 488.0 and 488.1. The consequence was six new influenza with pneumonia codes for the 2011 ICD-9 update:
Disorder of fluency
After this, there are some changes to the fluency disorder ICD-9 codes. New code titles will help distinguish childhood onset fluency disorder, adult onset fluency disorder, and – here is where it picks up interest for home care – fluency disorder following brain lesion or disease.
Probably, you will remember that (Late effects of cerebrovascular disease, fluency disorder) was implemented on October 1 last year. The plan for this year is to alter the inclusion term “Stuttering” at 438.14 to read “Stuttering due to late effect of cerebrovascular accident”.
Other such changes include revising 307.0 to read “Stuttering; Adult onset fluency disorder” and adding up new code 315.35 (Childhood onset fluency disorder).
Right now, you have specific codes for compilations of all sorts of artificial stomas; however not for a cystostomy. If you are trying to code for an infected cystostomy, you have got 997.5 (Urinary complications) or 996.39 (Mechanical complication of other genitourinary device, implant, and graft); however these codes do not specify that the compilation is with the cystostomy or that there’s an infection. For the coming year, one can look forward to four new codes that’ll rectify this problem.
Use added code to specify type of infection
Malfunction of cystostomy
Postoperative Aspiration Pneumonia
There’s confusion when it comes to coding aspiration pneumonia resulting from a procedure code 997.39 (Other respiratory complications), includes aspiration pneumonia complicating a procedure; however there’s a use additional code note at the start of the category to find out the complication.
This left coders with a sticky situation. Should they pair 507.0 (Pneumonitis due to inhalation of food or vomitus) with code 997.39? Or should they go for just 997.39 since aspiration pneumonia is an inclusion term.
The proposal for the next year is add a new code and to change the instructional notes at categories 507 and 997 to help coders in choosing the right codes for this complication.
You will see the following new and modified codes:
Add Excludes: postprocedural pneumonitis (997.32)
Postprocedural aspiration pneumonia
Chemical pneumonitis ensuing from a procedure
Mendelson’s syndrome ensuing from a procedure
Remove Mendelson’s syndrome resulting from a procedure
Remove Pneumonia (aspiration) resulting from a procedure
These codes were found in the Federal Register as part of the proposed Hospital Inpatient PPS rule; however we will not know the final list of new and changed codes for a few months to come. So stay tuned to these home health ICD-9 codes.