August 2007

Start your coding & documentation training for newest ICD-9-CM codes
E/M Tip of the Month
Study Guides Now Available In Your Specialty
Mark Your Calendars for the 2008 Specialty Coding Extravaganza
Upcoming Events

Hello from the Board of Medical Specialty Coding! We hope you enjoy your monthly ezine and find the information useful. If you have any comments or recommendations for future issues, please contact me through the following channels:

Victoria Forlini, Executive Director
vforlini@medicalspecialtycoding.com
301/287-2250 (phone)
301/287-2941 (fax)

Start your coding & documentation training for newest ICD-9-CM codes

The Centers for Medicare & Medicaid Services (CMS) has published most of the ICD-9-CM diagnosis code changes that will take effect Oct. 1. Get ready for them now.

Practices that see lymphoma patients will notice the most changes: You have 54 new codes in categories 200.30-200.78 and 202.70-202.78 to describe different types of lymphoma in various regions of the body. While that means your coding can be more specific to the patient’s condition and help support medical necessity, it also means you’ll need to educate your physicians to document the type of lymphoma being treated and the very precise location.

Examples of the new lymphoma codes : 200.32 (marginal zone lymphoma, intrathoracic lymph nodes); 200.43 (mantle cell lymphoma, intra-abdominal lymph nodes); 200.54 (primary central nervous system lymphoma, lymph nodes of axilla and upper limb); 200.65 (anaplastic large cell lymphoma, lymph nodes of inguinal region and lower limb); 200.76 (large cell lymphoma, intrapelvic lymph nodes); and 202.77 (peripheral T cell lymphoma, spleen). You’ll also find four new codes (233.3x) for carcinoma in situ of female genital organs.

So far, the 2008 ICD-9-CM update includes 144 new, five revised and 16 invalid codes slated to take effect Oct. 1. It was released as part of the CMS hospital Inpatient Prospective Payment System (IPPS) proposed rule. See the codes at: www.cms.hhs.gov/AcuteInpatientPPS/downloads/CMS-1533-P.pdf. (Note: a few additional codes may be added as a result of discussions at the March ICD-9-CM Coordination and Maintenance Committee meeting.)

Some other code changes of interest:

• Human herpes virus . Eight new codes (058.xx) describe infection, encephalitis and roseola infantum linked to human herpes virus 6 or human herpes virus 7.
• Hearing loss . Two new codes let you code speech/ language developmental delays due to hearing loss (315.34) and acquired auditory processing disorders (388.45). In addition, seven new codes in expanded category 389.xx will allow you to identify whether hearing loss is conductive, neural, sensory or mixed, as well as whether it’s unilateral or bilateral. Also note new V code V72.12 (encounter for hearing conservation and treatment).
• Myotonic disorders . Be aware of five new 359.2x codes for these muscle spasm disorders. Gone is the sole code 359.2 that lumps together all myotonic disorders. You now have to distinguish among codes for myotonic muscular dystrophy, congenital myotonia, myotonic chondrodystrophy, drug induced myotonia and other specified myotonic disorder.
• Avian flu . Check out new code 488 (influenza due to identified avian influenza virus).
• Swallowing function . Say goodbye to single dysphagia code 787.2. You’ll have six new 787.2x codes for various “phases” of dysphagia, such as 787.21 (dysphagia, oral phase) or 787.23 (dysphagia, pharyngeal phase).
• Personal history of cardiac problems. Two new codes V12.53 and V12.54 will allow you to code “personal history of sudden cardiac arrest” and “personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits,” respectively.
• Family history of cardiac problems. Two additional V codes, V17.41 and V17.49, will let you code for “family history of sudden cardiac death (SCD),” and “family history of other cardiovascular diseases,” respectively.
• Procreation counseling/management. Practices that provide family planning services should take note of five new codes V25.04 (counseling and instruction in natural family planning to avoid pregnancy), V26.41 (procreative counseling and advice using natural family planning), V26.49 (other procreative management, counseling and advice), V26.81 (encounter for assisted reproductive fertility procedure cycle), and V26.89 (other specified procreative management).

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E/M Tip of the Month
Test your E/M coding skills by identifying the answer to this question:

Can a provider provide a second consultative service to the same patient in an office setting? Yes or No?

Find out the answer at the bottom of this email newsletter. Also check this space monthly for the E/M Tip of the month.

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Study Guides Now Available In Your Specialty

BMSC now has study guides available to help you prepare for certification in your specialty.

These study guides are different than you expect, as they are full of exam tips and notes from the editors, providing you with helpful hints as to how to get ready to sit for your examination and become certified.

Each guide is smaller than you expect: they are 6x9 and able to slip right in your purse or briefcase. And most importantly, each guide is no more than 100 pages. Now you can take your time and concentrate on the major points that you need to know for your exam.

Visit www.medicalspecialtycoding.com to order study guides in:

• Anesthesia Coding Certification
• Cardiology Coding Certification
• Evaluation and Management Auditing Coding Certification
• Radiology Coding Certification
• Family Practice/Pediatrics Coding Certification
• Orthopedics Coding Certification
• Pain Management Coding Certification
• Emergency Medicine Coding Certification

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Mark Your Calendars for the 2008 Specialty Coding Extravaganza

Mark your calendar for the only specialty-specific coding program of its kind –

6th Annual Specialty Coding Extravaganza 2008
February 12-14, 2008
Royal Pacific Resort at Universal Orlando

The top coding experts in your specialty… specialty-specific instruction on the top procedures and services you bill most often… 2008 changes for your specialty… hands-on coding exercises to stretch your skills… specialty coding certification and CEUs… networking with other coders in your specialty… the Specialty Coding Extravaganza, February 12-14, 2008 -- it’s all about YOU and your specialty.

Watch the conference website for program details www.extrav2008.com or call 866-620-5939.

Upcoming Events

Here's the 411 on some upcoming events where you'll get top-notch educational opportunities to earn CEUs and even a place to sit for your specialty certification or recertification exam!

Event: Intestinal Surgery: Learn the Coding Mysteries of 24 to 30 Feet of Twists and Turns
Date: September 5, 2007
To register or to learn more information:
http://www.decisionhealth.com/conferences/A1248/home.html

Event: Office Hours with Kelly Dennis and Samantha Mullins
Date: September 18, 2007, 1:00-2:00 p.m.
To register or to learn more information:
http://www.decisionhealth.com/conferences/A1372/home.html

Event: Billing and Coding Pain Management
Date: October 10-12, 2007
To register or to learn more information:
http://www.decisionhealth.com/conferences/pain2007/index.html

Event: Improve Billing, Coding and Profitability for Freestanding ASC's
Date: October 15-16, 2007
To register or to learn more information:
http://www.specialtyconferences.com/asc/index.html

Event: Medical Practice Management Summit 2007
Date: November 12-14, 2007
To register or to learn more information:
http://www.decisionhealth.com/conferences/summit2007/

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Answer to the E/M Tip of the Month is..

Yes. You may use office/outpatient consultation codes 99241-99245 for an additional consultation requested of the same consulting physician or qualified NPP if the consultant has not been providing ongoing management of the patient for this condition after his/her initial consultation.

Source: http://www.cms.hhs.gov/MLNMattersArticles/
downloads/MM4215.pdf