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Medical Coding News Archives

March 2012 Coordination and Maintenance Committee Code Proposal Highlights

March 21, 2012:

Due to the partial code freeze, the March 5, 2012, ICD-9-CM Coordination and Maintenance Committee Meeting at the headquarters of the Centers for Medicare and Medicaid Services in Baltimore was brief, adjourning before 12:30 p.m.

No new proposed ICD-9-CM diagnosis codes were presented for consideration at this meeting. However, the following four new proposed ICD-10-CM diagnosis topics were presented for consideration and discussed:

  • Atypical femoral fracture—This topic was initially presented at the March 2011 meeting. In the interim, submitted comments expressed concern about the term “atypical” and requested specific clinical case definition. Proposed ICD-10-CM code assignments include the creation of 18 new subclassification codes within subcategory M84.35 Stress fracture, pelvis and femur or 60 new codes within a unique subcategory M84.7 Nontraumatic fracture, not elsewhere classified, which would facilitate type, site, and laterality of fracture.
  • Choking game—A new Y93 Activity code was proposed to identify injuries sustained among children and adolescents while playing the “choking,” “fainting,” or “blackout” game, which involves intentional choking of oneself or others, by use of hands, noose, or other article of clothing to induce a brief hypoxia-related euphoria. Associated injuries include neck injury, concussion, and skull and limb fractures due to fall. Serious complications include flash pulmonary edema, coma, and death by asphyxiation.
  • Cognitive sequelae of cerebrovascular diseases—These conditions may include impaired concentration, memory, visuospatial perception, psychomotor function and other cognitive functions following stroke. More than 40 new ICD-10-CM codes were proposed to classify these conditions to category I69 Sequelae of cerebrovascular disease, by causal event and type. Support was expressed for the addition of these codes to ICD-10-CM to align with other currently classified ICD-10-CM conditions that represent motor, speech, and language deficits following stroke.
  • Family history of SIDS—A new ICD-10-CM code was proposed to report risk factors associated with sudden infant death syndrome occurring in siblings and twins. It was proposed that a new code would assist in research into the hierarchy of risk due to biological or environmental factors. Proposed code Z84.82 Family history of sudden infant death syndrome was discussed. It was suggested that instead, a personal history code would be more appropriate to report a biological sibling with SIDS and would specifically identify such patients, in alignment with clinical risk factors.

See the ICD-10-CM proposed index and tabular addenda for additional proposed changes to the diagnostic classification. The following two new proposed ICD-9-CM procedure codes were presented for discussion:

  • Administration of fidaxomicin—A new code was proposed for the oral administration of Dificid® (fidaxomicin) for treating Clostridium difficile gastrointestinal infections. Dificid is clinically superior to vancomycin therapy, the risks of which include relapse or drug resistance. Comments cautioned against the adoption of a new code for oral drug administration, which is considered part of the conservative treatment of care. Adding a code for administration of an oral drug would be a departure from standard ICD-9-CM coding and reporting practice.
  • Injection or infusion of glucarpidase (Voraxaze®)—This is currently reported by code 99.29 Injection or infusion of other therapeutic or prophylactic substance. A unique code (00.95) was proposed for this drug therapy, which is the only approved pharmaceutical treatment option for patients with toxic methotrexate concentrations due to renal impairment.


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