ICD-9-CM Expert for Home Health Services, Nursing Facilities, and Hospices Volumes 1, 2 & 3 International Classification of Diseases 9th Revision Clinical Modification Sixth Edition Edited by: Anita C. Hart, RHIA, CCS, CCS-P Catherine A. Hopkins Beth Ford, RHIT, CCS Ingenix is committed to providing you with the ICD-9-CM code update information you need to code accurately and to be in compliance with HIPAA regulations. In the case of adoption of additional ICD-9-CM code changes effective April 1, 2006, Ingenix will provide these code changes to you at no additional cost! Just check back at http://www.IngenixOnline.com and look for the ICD-9-CM Update icon to review the latest information concerning any new code changes. Codes Valid October 1, 2005, through September 30, 2006 Tabular List RESPIRATORY SYSTEM 484–491.20 ' 484 Pneumonia in infectious diseases classified elsewhere Bronchioli and Alveoli E X C L U D E S influenza with pneumonia, any form (487.0) 484.1 <<¥Pneumonia in cytomegalic inclusion disease Code first underlying disease (078.5) 484.3 <¥Pneumonia in whooping cough Code first underlying disease (033.0-033.9) 484.5 <¥<Pneumonia in anthrax Code first underlying disease (022.1) 484.6 <<¥Pneumonia in aspergillosis Code first underlying disease (117.3) AHA: 4Q, ‘97, 40 484.7 <¥<Pneumonia in other systemic mycoses Code first underlying disease E X C L U D E S pneumonia in: candidiasis (112.4) coccidioidomycosis (114.0) histoplasmosis (115.0-115.9 with fifth-digit 5) 487.8 With other manifestations 484.8 <<¥Pneumonia in other infectious diseases Encephalopathy due to influenza <<¥classified elsewhere Influenza with involvement of gastrointestinal tract Code first underlying disease, as: E X C L U D E S “intestinal flu” [viral gastroenteritis] Q fever (083.0) (008.8) typhoid fever (002.0) E X C L U D E S pneumonia in: CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ALLIED actinomycosis (039.1) CONDITIONS (490-496) measles (055.1) AHA: 3Q, ‘88, 5 nocardiosis (039.1) ornithosis (073.0) 490 Bronchitis, not specified as acute or chronic Pneumocystis carinii (136.3) Bronchitis NOS: Tracheobronchitis NOS salmonellosis (003.22) catarrhal toxoplasmosis (130.4) with tracheitis NOS tuberculosis (011.6) E X C L U D E S bronchitis: tularemia (021.2) allergic NOS (493.9) varicella (052.1) due to fumes and vapors (506.0) 485 ¥>Bronchopneumonia, o¥>rganism unspecified ' 491 Chronic bronchitis Bronchopneumonia: Pneumonia: E X C L U D E S chronic obstructive asthma (493.2) hemorrhagic lobular 491.0 Simple chronic bronchitis terminal segmental Catarrhal bronchitis, chronic Pleurobronchopneumonia Smokers’ cough E X C L U D E S bronchiolitis (acute) (466.11-466.19) 491.1 Mucopurulent chronic bronchitis chronic (491.8) Bronchitis (chronic) (recurrent): lipoid pneumonia (507.1) fetid 486 ¥>Pneumonia, organ¥>ism unspecified mucopurulent E X C L U D E S hypostatic or passive pneumonia (514) purulent influenza with pneumonia, any form (487.0) AHA: 3Q, ‘88, 12 inhalation or aspiration pneumonia due to foreign materials (507.0-507.8) DEF: Chronic bronchial infection characterized by both mucus and pneumonitis due to fumes and vapors (506.0) pus secretions in the bronchial tree; recurs after asymptomatic AHA: 4Q, ‘99, 6; 3Q, ‘99, 9; 3Q, ‘98, 7; 2Q, ‘98, 4, 5; 1Q, ‘98, 8; 3Q, ‘97, 9; periods; signs are coughing, expectoration and secondary changes 3Q, ‘94, 10; 3Q, ‘88, 11 in the lung. ' 487 Influenza k 491.2 Obstructive chronic bronchitis Bronchitis: E X C L U D E S Hemophilus influenzae [H. influenzae]: emphysematous infection NOS (041.5) obstructive (chronic) (diffuse) laryngitis (464.00-464.01) Bronchitis with: meningitis (320.0) chronic airway obstruction 487.0 ¥>With pne¥>umonia emphysema Influenza with pneumonia, any form E X C L U D E S asthmatic bronchitis (acute) NOS Influenzal: (493.9) bronchopneumonia chronic obstructive asthma (493.2) pneumonia AHA: 3Q, ‘97, 9; 4Q, ‘91, 25; 2Q, ‘91, 21 wUse additional code to identify the type of pneumonia (480.0-480.9, 481, 482.0-482.9, 491.20 Without exacerbation 483.0-483.8, 485)x Emphysema with chronic bronchitis 487.1 With other respiratory manifestations AHA: 3Q, ‘97, 9 Influenza NOS Influenzal: laryngitis pharyngitis respiratory infection (upper) (acute) AHA: 4Q, ‘99, 26 ' Additional Digit Required RUG III Special Care Dx RUG III Clinically Complex Dx Hospice Non-cancer Dx CD PDx Clinical Dimension PDx CD SDx Clinical Dimension SDx k 2006 ICD•9•CM October 2005 • Volume 1 — 133 Tabular List DIAGNOSTIC AND THERAPEUTIC PROCEDURES 92.24–93.37 92.24 ¥>Teleradiotherapy using photons 93.08 <¥>Electromyography Megavoltage NOS E X C L U D E S eye EMG (95.25) Supervoltage NOS that with polysomnogram Use of: (89.17) Betatron urethral sphincter EMG (89.23) linear accelerator AHA: J-F, ‘87, 16 92.25 ¥>Teleradiotherapy using electrons DEF: Graphic recording of electrical activity of muscle. Beta particles 93.09 <¥>Other diagnostic physical therapy procedure 92.26 Teleradiotherapy of other particulate ¥> ' 93.1 Physical therapy exercises ¥>radiation Neutrons Protons NOS AHA: J-F, ‘87, 16; N-D, ‘86, 7 92.27 ¥><Implantation or insertion of radioactive 93.11 <¥>Assisting exercise ¥><elements E X C L U D E S assisted exercise in pool Intravascular brachytherapy (93.31) Code also incision of site 93.12 ¥><Other active musculoskeletal exercise E X C L U D E S w infusion of liquid 93.13 <¥>Resistive exercise brachytherapy 93.14 <¥>Training in joint movements radioisotope (92.20)x 93.15 Mobilization of spine AHA: 1Q, ’04, 3-4; 1Q, ‘00, 11, 12; 3Q, ‘94, 11; 1Q, ‘88, 4 <¥> 93.16 <¥>Mobilization of other joints 92.28 ¥>Injection or instillation of radioisotopes E X C L U D E S manipulation of temporo - Injection or infusion of mandibular joint (76.95) radioimmunoconjugate 93.17 ¥><Other passive musculoskeletal exercise Intracavitary injection or instillation Intravenous injection or instillation 93.18 <¥>Breathing exercise Iodine-131 [I-131] tositumomab 93.19 ¥><Exercise, not elsewhere classified Radioimmunotherapy ' 93.2 Other physical therapy musculoskeletal Ytrium-90 [Y-90] ibritumomab tiuxetan manipulation E X C L U D E S w infusion of liquid AHA: N-D, ‘86, 7 brachytherapy 93.21 ¥>Manual and mechanical traction radioisotope (92.20)x E X C L U D E S skeletal traction (93.43-93.44) 92.29 ¥>Other radiotherapeutic procedure skin traction (93.45-93.46) ' 92.3 Stereotactic radiosurgery spinal traction (93.41-93.42) Code also stereotactic head frame application (93.59) 93.22 ¥>Ambulation and gait training E X C L U D E S stereotactic biopsy 93.23 ¥>Fitting of orthotic device AHA: 4Q, ‘98, 79; 4Q, ‘95, 70 93.24 ¥>Training in use of prosthetic or orthotic DEF: Ablation of deep intracranial lesions; single procedure; ¥>device placement of head frame for 3-D analysis of lesion, followed by Training in crutch walking radiation treatment from helmet attached to frame. 93.25 ¥>Forced extension of limb 92.30 <Stereotactic radiosurgery, not otherwise 93.26 ¥>Manual rupture of joint adhesions <specified DEF: Therapeutic application of force to rupture 92.31 <Single source photon radiosurgery adhesions restricting movement. High energy x-rays Linear accelerator (LINAC) 93.27 ¥>Stretching of muscle or tendon 92.32 <Multi-source photon radiosurgery 93.28 ¥>Stretching of fascia Cobalt 60 radiation 93.29 ¥>Other forcible correction of deformity Gamma irradiation AHA: N-D, 85, 11 AHA: 4Q, ’04, 113 ' 93.3 Other physical therapy therapeutic procedures 92.33 <Particulate radiosurgery 93.31 ¥>Assisted exercise in pool Particle beam radiation (cyclotron) 93.32 ¥>Whirlpool treatment Proton accelerator 93.33 ¥>Other hydrotherapy 92.39 <Stereotactic radiosurgery, not elsewhere 93.34 Diathermy <classified ¥> 3 93 Physical therapy, respiratory therapy, rehabilitation, and 93.35 ¥>Other heat therapy related procedures Acupuncture with smouldering moxa Hot packs ' 93.0 Diagnostic physical therapy Hyperthermia NEC AHA: N-D, ‘86, 7 Infrared irradiation 93.01 <¥>Functional evaluation Moxibustion Paraffin bath 93.02 ¥>Orthotic evaluation E X C L U D E S hyperthermia for treatment of 93.03 ¥>Prosthetic evaluation cancer (99.85) 93.04 ¥>Manual testing of muscle function DEF: Moxibustion: Igniting moxa, a Chinese plant, for AHA: J-F, ‘87, 16 counterirritation of skin. 93.05 <¥>Range of motion testing DEF: Paraffin bath: Hot wax treatment. AHA: J-F, ‘87, 16 93.36 ¥>Cardiac retraining 93.06 <¥>Measurement of limb length DEF: Cardiac rehabilitation regimen following 93.07 <¥>Body measurement myocardial infarction or coronary bypass graft Girth measurement procedure. Measurement of skull circumference 93.37 Prenatal training Training for natural childbirth ' Additional Digit Required RUG III Special Care Procedure RUG III Clinically Complex Procedure RUG III Extensive Services Procedure RUG III Rehab Procedure k 2006 ICD•9•CM October 2005 • Volume 3 — 199 Coding Guidelines Coding Guidelines ICD-9-CM OFFICIAL GUIDELINES FOR CODING 8. “With” 9. “See” and “see also” AND REPORTING B. General coding guidelines Effective April 1, 2005 1. Use of both Alphabetic Index and Tabular List Narrative changes appear in bold text The guidelines have been updated to include the V Code Table. 2. Locate each term in the Alphabetic Index 3. Level of detail in coding The Centers for Medicare and Medicaid Services (CMS) and the National 4. Code or codes from 001.0 through V85.4 Center for Health Statistics (NCHS), two departments within the U.S. Federal Government’s Department of Health and Human Services (DHHS) provide the 5. Selection of codes 001.0 through 999.9 following guidelines for coding and reporting using the International 6. Signs and symptoms Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). 7. Conditions that are an integral part of a disease process These guidelines should be used as a companion document to the official 8.