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ICD-9-CM Code Changes for 2010

May 26, 2009:

Although the official ICD-9-CM addendum for volumes 1, 2, and 3 has not been released, we can still get a glimmer of the changes we will face for fiscal year 2010. The code count below is based upon the new and revised code list released with the proposed rule for the inpatient prospective payment system (IPPS) for fiscal 2010 and as posted on the Centers for Medicare and Medicaid Services ICD-9-CM website. There may still be modifications made once the addendum is released.

New valid diagnosis codes: 311
Revised valid diagnosis codes: 45
Invalid diagnosis codes: 22

New valid procedure codes: 11
Revised valid procedure codes: 14
Invalid procedure codes: 0

New Code Highlights

Regardless of the specialty, the code revisions will affect all providers. Below is an explanation of some of the new codes for 2010. 

Merkel cell carcinoma (209.31–209.36, 209.75): This is an aggressive neuroendocrine skin cancer with a rising incidence, making this one of the most common causes of nonmelanoma skin cancer deaths in the United States.

Secondary neuroendocrine tumors (209.70–209.74, 209.79): New codes were added for secondary sites of tumors associated with a wide range of hormonal syndromes, commonly respiratory and gastrointestinal.

Gouty arthropathy (274.00–274.03): New codes differentiate between the stages of gouty arthropathy which is critical in determining appropriate treatment regimens.

Chemotherapy-induced anemia (285.3): Anemia is the most common side-effect of chemotherapy.

Acute chemical conjunctivitis (372.06): Common irritants such as swimming pool chlorine or household cleaners can cause significant risk to vision but must be differentiated from serious alkaline or acid chemicals burns to the eye.

Chronic pulmonary embolism (416.2): This code identifies patients who are no longer in the acute stage of pulmonary embolism but are receiving treatment such as anticoagulant therapy.

Acute and chronic venous embolism and thrombosis (453.50–453.52, 453.6, 453.71–453.79, 453.81–453.82): Changes include new terminology, new site specificity, and new differentiation between deep and superficial vessels for venous embolism and thrombosis.

New late effects of cerebrovascular disease, dysarthria (438.13) and fluency disorder (438.14)

Nursemaid’s elbow (832.2): This code describes common subluxation of the elbow in children under the age of 5.

Hypoxic-ischemic encephalopathy (HIE) (768.70–768.73): Cerebral injury during the perinatal period, unrelated to the birth process, can now be coded according to clearly defined clinical severity.

Perinatal conditions: Codes were added to identify other newborn conditions such as feeding problems (779.31), vomiting (779.32–779.33) and failure to thrive (779.39).

There are a number of new symptom codes to identify specific voice disturbances (784.42–784.44), bilious emesis (787.04), colic (789.7), inconclusive mammogram (793.82), types of nervousness(799.21–799.29), and apparent life-threatening events in an infant (ALTE) have been added.

There are also 32 new V codes that cover personal history of disease, health supervision of newborns, fitting and adjustment of gastrointestinal devices, family disruption issues, substance abuse issues, personal history of specific therapies (estrogen, steroid, immunosuppressive), and new specific screening codes.

The E code section was expanded with the creation of 104 new activity E codes to identify the specific activity in which the person was engaged that resulted in injury or other health condition. There are also 48 new E codes that identify more specifically injury due to war operations.

These are only the highlights, and more new codes are expected to come. There will also be numerous index changes, instructional note changes, revised code titles, and coding guideline revisions for 2010.

Anita Hart
Product Manager


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