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ICD 9 Codes: Pregnancy Screening and Complications

<div dir="ltr" style="text-align: justify;" trbidi="on">Codes for complications of pregnancy, childbirth, and the puerperium appear in Chapter 11 in ICD-9-CM. They move to Chapter 15 in ICD-10-CM. In ICD-9-CM, you often need a fifth character to denote whether the mother gave birth during the encounter. For example, if a patient is diagnosed with transient hypertension in pregnancy, you would report 642.3x. The fifth digit denotes:<br />
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0, unspecified as to episode of care or not applicable <br />
1, delivered, with or without mention of antepartum condition<br />
2, delivered, with mention of postpartum complication<br />
3, antepartum condition or complication <br />
4, postpartum condition or Complication<br />
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Depending on the demographics of the region a hospital serves, its coders could determine code assignment for hundreds of deliveries and pregnancy-related services annually. Therefore, reviewing the related coding guidelines is helpful. Coders must remember that pregnancy is a disease process separate from other disease processes that patients may experience. A pregnancy diagnosis is always reported first, she says. This may seem counterintuitive to coders trained to report the principal diagnosis as the condition after study that is chiefly responsible for admission.<br />
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<div style="text-align:center;"><a href="http://www.medicalbillingcodings.org/2014/06/ICD9Codes-Pregnancy-Screening-Complications.html"><img alt="ICD 9 Codes: Pregnancy Screening and Complications" border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEibDZ1-yih9dWlFFPPc6ns9Rfj6tC8DJYBjiVguTXNW6ZiBKQlQ_s4IyJVid40n_OpcMFq-0rbnSKmIsdI-kqcPgKoIbOgpq2Uk3INoldnrRR-U0wXUzs1cAjVzWnugqsBShtvdzg4IpDE/s1600/pregnancy-yoga.jpg" /></a></div><br />
<h3>Pregnancy Screening and Complications ICD 9 Diagnosis Codes</h3>Current guidelines indicate that ICD-9-CM code 648.21 is the principal diagnosis for a woman with a pregnancy complicated by anemia who undergoes a cesarean delivery due to fetal distress not present at admission.<br />
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<h4>Decreased Fetal Movement</h4>Decreased fetal movement (655.7x)—a condition in which a mother cannot feel the fetus move—can be an early sign of a problematic pregnancy. ¬Physicians often document this term before administration and interpretation of a fetal non-stress test that indicates normal development.<br />
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The following documentation is necessary to help ¬determine whether decreased fetal movement is present:<br />
<ul><li>Was the fetus stressed during the fetal non-stress test?</li>
<li>How many heartbeats per minute, including accelerations and decelerations, did the fetus have during the test? Is this normal?</li>
<li>How many contractions occurred during the test?</li>
<li>What was the patient's blood pressure during the test?</li>
<li>Was the patient hydrated or dehydrated during the test?</li>
</ul><br />
<h4>Fetal Conditions and Management of Mothers</h4>Coders should assign codes from the following categories only when the fetal condition is responsible for modifying management of a mother:<br />
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655, known or suspected fetal abnormality affecting management of the mother<br />
656, other known or suspected fetal and placental problems affecting management of the mother<br />
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For example, report fetal conditions that require termination of a pregnancy, diagnostic ¬studies, additional observation, or special care. The mere existence of a fetal condition does not justify assigning a code for that condition, according to the guidelines.<br />
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<h4>Abortions</h4>The term abortion has a legal connotation, but several more specific terms are also associated with this diagnosis, says Webb. These include the following:<br />
<ul><li>Spontaneous abortion, including miscarriage (634.x)</li>
<li>Legally induced abortion (635.x)</li>
<li>Illegally induced abortion (636.x)</li>
<li>Unspecified abortion, including retained products of conception following abortion, not classified elsewhere (637.x)</li>
<li>Failed attempted abortion (638.x)</li>
</ul><h4>Intrapartum Care</h4>Coders often forget to report codes for ¬complications that occur during labor and delivery (codes 660-669), says Webb. For example, when a delivery trauma, such as an episiotomy (73.6), occurs, ¬coders often forget to report a code for cervical laceration (655.3x).<br />
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ICD 9 Codes: Pregnancy Screening and Complications

Codes for complications of pregnancy, childbirth, and the puerperium appear in Chapter 11 in ICD-9-CM. They move to Chapter 15 in ICD-10-CM. In ICD-9-CM, you often need a fifth character to denote whe…

ICD 9 Codes for Depression, Anxiety w/o Insomnia, Fatigue etc

<div dir="ltr" style="text-align: justify;" trbidi="on">View ICD 9-cm codes for COPD Exacerbation, Asthma, Bronchitis, Emphysema. Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases. <br />
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Some people’s depression is attributed to physical illness while other develop physical symptoms because of being depressed. It is estimated that about 5% to 13% of patients in primary care suffer from major depression<br />
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We have also been writing about all types of <a href="http://www.medicalbillingcodings.org/2013/10/icd-10-cm-codes-for-hypertension-htn.html">ICD 10 CM Codes for Hypertension</a>, <a href="http://www.medicalbillingcodings.org/2012/12/icd9codes-Hypertension-HTN-401-405.html">ICD 9 Code for Hypertension</a> (HTN) from 401 to 405, <a href="http://www.medicalbillingcodings.org/2013/11/icd10codes2014depression-mild-moderate-severe-psychotic-bipolar.html">ICD-10 Codes for Depression</a> and <a href="http://www.medicalbillingcodings.org/2013/11/icd10codes-mentalhealthdisorders2014.html">ICD 10 Codes for Mental Disorders</a>. <br />
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Depression is a type of mood disorder that is characterized by a persistent feeling of sadness or loss of interest. Major depressive disorder or clinical depression affects how one feels, think  and behave and is known to lead to a variety of emotional and physical problems. People suffering from depression find it extremely impossible to carry out normal day to day activities known to make many people feel not worth living.<br />
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<div style="text-align:center"><a href="http://www.medicalbillingcodings.org/2014/06/ICD9cm-codes-depression-anxiety-insomnia-fatigue.html"><img alt="ICD 9 Codes for Depression, Anxiety w/o Insomnia, Fatigue and Psychotic Features" border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXJ9FFoMcYTgpZMT-XeiX_zD4PNRb8lraw2RwONtPSP8R2O-XLdQBK9o5co-_sNRiXpYD8fDoJIJMgV_Gear6cwuw5diO4nSN9DWy85Ad0xymuHnhdJfkzLnc2IFQsNDG-3-hTJExZSkhW/s1600/depression-in-men.jpg" /></a></div><br />
<h3>ICD 9 Codes for Depression/Anxiety</h3>Multiple diagnosis codes exist for coding for depression. The most general is 311, <b>Depressive Disorder</b>, not elsewhere Classified. Code 290.21 represents senile dementia with depressive features. Several codes can be used for reporting acute depression, including 296.2, Major depressive disorder, single episode. ICD 9cm code 296.3 is used for Major depressive disorder, recurrent episode. <small>(Note that both of these codes require a fifth digit)</small><br />
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ICD 9 Code <b>300.4 Neurotic depression</b> also referred to as "reactional depression" can be used to code depression brought on by personal change or unexpected circumstances. This type of depression can become chronic unless treated, and the affected individual is able to function normally. <br />
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In comparison, <b>Situational Depression</b>, which is transient and tends to impair an individual’s ability to function more significantly than neurotic depression, may be coded as 309.0 (brief) or 309.1 (prolonged).<br />
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Maternity-related depression should be coded using 648.4 A fifth digit is required to denote the current episode of care. For example, <b>Postpartum Depression</b> would be coded as 648.44. <br />
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When a definitive diagnosis of depression is not or cannot be made, the patient’s presenting symptoms should be coded instead. For example, if a patient presents complaining of fatigue and malaise, you could code the visit using 780.79, <b>Depression with Malaise and Fatigue</b>. <br />
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<h3>Depression Medical Billing</h3>Unfortunately, some family physicians are tempted to code a patient’s symptoms, even in the face of a definitive diagnosis. They may do so to avoid conflict with the patient, ensure insurance coverage or to help the patient avoid the larger copays/ coinsurances sometimes associated with mental health care. <br />
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While such "Creative Coding" is well intended, it is not recommended as standard Medical Billing Coding practice. It exposes physicians to potential fraud and abuse liability. It also obscures the reported incidence of depression in the primary care setting and contributes to the perception in some circles that family physicians are not capable of diagnosing and treating depression. Above all, it stand contrary to the Correct Coding principles.<br />
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Family physicians may diagnose and treat depression in the context of evaluation and management (E/M) services. Depression may be secondary to another diagnosis or it may be a primary diagnosis if the patient presents with symptoms that lead to a depression diagnosis or if depression has previously been diagnosed and is the reason for the patient’s visit.<br />
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Coding for the diagnosis and treatment of depression is fraught with peril. Some patients may not like the diagnosis and some payers may not cover the service. However, if those obstacles can be overcome, diagnosis and treatment of depression can pay as well as the diagnosis and treatment of other conditions commonly seen in family medicine.<br />
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</ol></div>

ICD 9 Codes for Depression, Anxiety w/o Insomnia, Fatigue etc

View ICD 9-cm codes for COPD Exacerbation, Asthma, Bronchitis, Emphysema. Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases. Some people’s depression is attributed …

COPD ICD 9CM Codes: Exacerbation, Asthma, Bronchitis, Emphysema

<div dir="ltr" style="text-align: justify;" trbidi="on">View ICD 9-cm codes for COPD Exacerbation, Asthma, Bronchitis, Emphysema. Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases. <br />
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Chronic obstructive pulmonary disease is a chronic bronchitis alpha-1 antitrypsin deficiency that is a genetic form of emphysema. The disease is most of the time characterized by the narrowing or obstruction of airflow and interference that hinders normal breathing. The primary risk factor for chronic obstructive pulmonary disease is smoking or second hand smoking, heredity and air pollution.<br />
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<div style="text-align:center"><a href="http://www.medicalbillingcodings.org/2014/06/COPD-ICD-9CM-Codes-Exacerbation-Asthma-Bronchitis-Emphysema.html"><img alt="COPD ICD 9CM Codes: Exacerbation, Asthma, Bronchitis, Emphysema" border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjQN9DRUHqDwhOkRp8TFboOxGSsPX4u3PCUH0gRlvrNWnICDLXE76vZbaI2DbY-CkgODveTjtSMkXwnMaMICWhR-HWO3rQDSBDKv85EmR8bB02dJPj20LGGuHRgmfjRDvPwdrASU-3jk1MK/s300/copd2.jpg" /></a></div><br />
<h3>COPD with Acute Bronchitis ICD 9CM Codes</h3>A diagnosis of COPD and acute bronchitis is classified to code 491.22. It is not necessary to assign code 466.0 (acute bronchitis) with 491.22. Code 491.22 is also assigned if the physician documents acute bronchitis with COPD exacerbation. However, if acute bronchitis is not mentioned with the COPD exacerbation, then code 491.21 is assigned (AHA Coding Clinic for ICD-9-CM, 2008, fourth quarter, pages 241-244).<br />
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<h3>ICD 9CM Code for COPD with Asthma</h3>Asthma with COPD is classified to code 493.2x. However, all coding directives in the Tabular List and index need to be reviewed to ensure appropriate  code assignment. A fifth-digit sub classification is needed to identify the presence of status asthmaticus or exacerbation.<br />
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<h3>COPD with Exacerbation</h3>Exacerbation is defined as a decompensation of a chronic condition. It is also defined as an increased severity of asthma symptoms, such as wheezing and shortness of breath. Although an infection can trigger it, an exacerbation is not the same as an infection superimposed on a chronic condition. Status asthmaticus is a continuous obstructive asthmatic state unrelieved after initial therapy measures. <br />
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If a physician documents both exacerbation and status asthmaticus on the same record, only assign the fifth digit "1" to show the status asthmaticus. Sequence the status asthmaticus code first if documented with any type of COPD or with acute bronchitis <small>(AHA Coding Clinic for ICD-9-CM, 2008, fourth quarter, pages 241-244)</small>.<br />
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COPD with exacerbation is classified to code 491.21, which also includes the following:<br />
<ul><li>Acute Exacerbation of COPD</li>
<li>Exacerbation of COPD</li>
<li>Decompensated COPD</li>
<li>Decompensated COPD with Exacerbation</li>
<li>COPD in Exacerbation</li>
<li>Severe COPD in exacerbation</li>
<li>End-stage COPD in exacerbation</li>
</ul>The word <b>Acute</b> need not be documented to assign code 491.21 for exacerbation of COPD (AHA Coding Clinic for ICD-9-CM, 2002, third quarter, page 18). <br />
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<blockquote>When the acute exacerbation of COPD is clearly identified, it is the condition that will be designated as the principal diagnosis. <small>(AHA Coding Clinic for ICD-9-CM, 1988, third quarter, pages 5-6).</small></blockquote><br />
According to current coding advice, acute exacerbation of COPD, acute bronchitis, and acute exacerbation of asthma is classified to codes 491.22 and 493.22 (AHA Coding Clinic for ICD-9-CM, 2006, third quarter, page 20).<br />
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Coding and sequencing for COPD are dependent on the physician documentation in the medical record and application of the Official Coding Guidelines for inpatient care. <br />
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<h3>COPD Diagnosis and Treatment</h3>After diagnosis, the most important and effective treatment for COPD is smoking cessation. The benefits of quitting smoking apply regardless of age, amount smoked, or severity of COPD.<br />
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In addition to medications, patients may require home oxygen, pulmonary rehab to improve overall quality of life and, in severe cases, surgery such as a lung transplant or lung volume reduction, during which the physician removes small wedges of damaged tissue.<br />
</div>

COPD ICD 9CM Codes: Exacerbation, Asthma, Bronchitis, Emphysema

View ICD 9-cm codes for COPD Exacerbation, Asthma, Bronchitis, Emphysema. Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases. Chronic obstructive pulmonary disease i…

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ICD 9 Codes: Pregnancy Screening and Complications

ICD 9 Codes for Depression, Anxiety w/o Insomnia, Fatigue etc

COPD ICD 9CM Codes: Exacerbation, Asthma, Bronchitis, Emphysema

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