ICD-9 FAQ

FAQ 1.  What is ICD-9?

ICD-9-CM (International Classification of Diseases, 9th edition, Clinical Modification) is a set of codes used by physicians, hospitals, and allied health workers to indicate diagnosis for all patient encounters. The ICD-9-CM is the HIPAA transaction code set for diagnosis coding.

The current International Classification of Diseases can trace its roots back to the Bertillon Classification first published in 1893. Starting in 1900, experts met about every 10 years under the auspices of the French government to revise the classifications. The fifth revision was published just before World War II. The World Health Organization took over responsibility for ICD in 1946 with publication of ICD-6. The intended purpose of the ICD-9 diagnosis codes (Volume 1 and 2) is for statistical tracking of diseases. Nothing more. Codes are added only when it can be demonstrated that it will help in the identification and monitoring of the disease.

The current edition in the United States for morbidity classification, ICD-9-CM, has been in use since 1979. The original intent for the diagnosis codes was for epidemiological and not billing functions, although in the US, the codes are used by payers for billing and reimbursement purposes.

ICD-9 diagnosis codes consist of 3-5 numeric characters representing illnesses and conditions, and alpha-numeric E codes, describing external causes of injuries, poisonings, and adverse effects; and V codes describe factors influencing health status and contact with health services.

ICD-9-CM consists of three volumes. Physicians use Volumes 1 and 2 only to assign diagnosis codes. Physicians use Current Procedural Terminology (CPT), published by the American Medical Association, to report medical and surgical procedures and physician service codes, rather than Volume 3 of the ICD-9-CM codes. The 3rd Volume of ICD-9-CM is used by Hospitals for reporting inpatient procedures and resource utilization.


FAQ 2.  What are the 2013 changes for ICD-9?

No changes were made to the 2013 ICD-9 code list pertinent to Emergency Medicine and only one revision was made to the entire manual.  There were several revisions to ICD-9-CM that affected Emergency Medicine for 2012. The updates were effective October 1, 2012. The 2012 changes represent the last major ICD-9-CM update prior to implementation of ICD-10-CM now anticipated for 2014.  Any further revisions to ICD-9-CM will only be for a new disease and/or representing new technology.  The 2012 code changes include the following codes:

Migraine and migraine variants 346.xx
Influenza due to identified novel influenza A virus with pneumonia 488.81
Influenza due to identified novel influenza A virus with other respiratory manifestations 488.82
Influenza due to identified novel influenza A virus with other manifestations 488.89
Respiratory conditions due to smoke inhalation 508.2
Primary spontaneous pneumothorax 512.81
Secondary spontaneous pneumothorax 512.82
Chronic pneumothorax 512.83
Other air leak 512.84
Other pneumothorax 512.89
Acute interstitial pneumonitis 516.33
Acute respiratory failure following trauma and surgery 518.51
Other pulmonary insufficiency, NEC, following trauma and surgery 518.52
Acute and chronic respiratory failure following trauma and surgery 518.53
Other nonspecific abnormal finding of lung field 793.19
Nonspecific reaction to tuberculin skin test without active tuberculosis 795.51
Multiple closed pelvic fractures without disruption of pelvic circle 808.44
Multiple open pelvic fractures without disruption of pelvic circle 808.54
Post-procedural aspiration pneumonia 997.32
Other digestive system complications 997.49
Postoperative shock 998.0x 
Bloodstream infection due to central venous catheter 999.32
Local infection due to central venous catheter 999.33
Acute infection following transfusion, infusion, or injection of blood 999.34
Anaphylactic reaction due to administration of blood and blood products 999.41
Anaphylactic reaction due to vaccination 999.42
Other serum reaction due to administration of blood and blood products 999.51
Other serum reaction due to vaccination 999.52
Personal history of gestational diabetes V12.21
Personal history of other endocrine, metabolic, and immunity disorders V12.29
Personal history of pulmonary embolism V12.55
Personal history of anaphylaxis V13.81
Pregnancy with history of ectopic pregnancy V23.42

View a complete list of 2013 ICD-9-CM revisions, additions, and deletions at http://www.cms.gov/ICD9ProviderDiagnosticCodes/07_summarytables.asp#TopOfPage

 

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