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 2014 changes for ICD-9?

No changes were made to the 2014 ICD-9 code list pertinent to Emergency Medicine.  The 2012 changes represent the last major ICD-9-CM update prior to implementation of ICD-10-CM scheduled for October 1, 2014. There were no ICD-9-CM diagnosis addenda for October 1, 2013. See ICD-10 FAQ for detailed information on transition from ICD-9.

FAQ 3.  When will I need to transition from ICD-9 to ICD-10?

The transition to ICD-10-CM/PCS will take place on October 1, 2015.  All users will transition on the same date.  If your program is covered by the Health Insurance Portability and Accountability Act (HIPAA) then transitioning to ICD-10 code sets is mandatory. 

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

Last Updated 06/2014

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