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2010 ICD-9-CM Update

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2010 ICD-9-CM codes became effective on October 1, 2009.  Locate the the complete update of ICD-9-CM codes in the August 27, 2009, Federal Register or on the CMS website.

Highlights include:

  • A multitude of new codes describing neoplasms, syndromes, or late effects of cancer treatment were added this year.  Merkel Cell Carcinoma and Other Neuroendocrine Tumor codes were added under 209.31-209.36 for primary sites and 209.70-209.79 for secondary sites.  V10.91 was also added to report a personal history of malignant neuroendocrine tumors.  Code 239.81 was added to report retina and choroid unspecified neoplasms that may represent retina melanoma or suspected choroid tumors. Tumor Lysis Syndrome, which is a group of metabolic complications that may occur following treatment of cancer, is now reported using 277.88.  Antineoplastic chemotherapy induced anemia is now coded as new code 285.3; therefore, no external cause code for the antineoplastic drug is necessary.
  • ICD-9-CM category 488 was retitled "Influenza due to certain identified influenza viruses" with new code 488.0 to identify Avian (bird) influenza.  Code 488.1 was added to report the currently high-profile H1N1 virus that is sweeping the country.
  • Subcategory "Endometrial Hyperplasia" now has two new codes to report and track specific conditions. Benign endometrial hyperplasia is now reported with 621.34 and endometrial intraepithelial neoplasia is to be reported using 621.35.  Endometrial intraepithelial neoplasia (EIN) which is treated with surgery or hormonal therapy is a premalignant lesion that may indicate an elevated risk for the patient to develop the most common form of uterine cancer.
  • Congenital abnormalities of the abdominal wall now have two new codes to report developmental deviations of the abdominal wall.  Oomphalocele, a ventral wall defect that occurs in one to two babies per 10,000 births, is now reported with 756.72.  Congenital gastroschisis is specifically reported with 756.73 instead of under the nonspecific code 756.79.  This condition is another ventral wall defect located near the umbilical insertion which is due to failure of the abdominal wall to close during fetal development.
  • Mild, moderate and severe degrees of hypoxic-ischemic encephalopathy now may be reported using 5th digit expanded codes 768.70-768.73 as recommended by the American Academy of Pediatrics.
  • Mammograms that are reported as "inconclusive" are to be reported with new ICD-9-CM code 793.82 which is expected to assist in communicating the need for additional testing to confirm the absence or presence of a malignancy to payers.
  • A number of V codes which help to describe special patient circumstances were added this year.  Code V15.83 describes the under immunization status of a patient or patients who are out of sync with their immunization schedule and may be at risk for disease.  Two new V codes were added for post hospital newborn care visits following delivery.  V20.31 describes health supervision for newborn under age eight days and V20.32 is for health supervision for newborn eight to 28 days old.  A great number of V codes for encounters for fertility, family disruption, counseling, laboratory examinations and personal history were also added and are worthy of review by providers.
  • One ICD-9-CM External Cause of Injury (E) code was revised and two new E codes were added to report events that are considered "Never Events".  These codes are as follows:
    • E876.5 - Performance of wrong operation on correct patient
    • E876.6 - Performance of operation on patient not scheduled for surgery
    • E876.7 - Performance of correct operation on wrong side/body part
  • Other External Cause of Injury Codes for activity status were created for 2010 ICD-9-CM to explain the patient status at the time the injury or event occurred.  Category E000 includes classification for "Civilian Activity done for income or pay" (E000.0); "Military Activity" (E000.1); "Other External cause status, such as leisure, recreation, sport, student or volunteer activities" (E000.8) and "Unspecified external cause status" (E000.9).  Categories E001-E030 were added to ICD-9-CM this year to better explain what the activity the patient was engaged in when the injury occurred.  An example would be "E001 - Activities involving walking and running" or "E003 - Activities involving ice and snow".  Military injury E Codes (E990.1- E998.9) were also added to explain injuries for improved reporting and tracking as requested by the Department of Defense.

These are just a few of the changes made to ICD-9-CM for 2010 as there are hundreds of other new, revised or deleted codes.  The finalized 2010 ICD-9-CM code changes demonstrate an increased specificity that details patients' conditions and histories.  Providers are advised to review the new codes as well as their documentation practices.

Reference:  AHIMA Journal - Coding Notes, 9/2/09