January 11, 2012
Effective October 1, 2011
The ICD-9-CM diagnosis code; 793.1 - Non specific (abnormal) findings on radiological and other examination of body structure; lung field, is frequently reported on FDG PET scan claims when PET is performed prior to biopsy for diagnosis of lung cancer in patients with lung masses, solitary pulmonary nodules and multiple pulmonary nodules.
This base four-digit code has been further specified with the addition of two new five-digit codes as follows:
793.1 – Nonspecific (abnormal) findings on radiological and other examination of body structure;
When selecting which ICD-9-CM diagnosis codes to submit on a claim, the code with the highest level of specificity should be used. Therefore, in situations where code 793.1 had been selected in the past, providers will now need to code to the higher level of specificity by selecting either 793.11 or 793.19, which ever is appropriate.
ICD-9-CM diagnosis code: 414.4 – Coronary atherosclerosis due to calcified coronary lesion is a new base four-digit code that has been added to the Ischemic Heart Disease (410-414) family of diagnosis codes. An instructional note: Code first coronary atherosclerosis (414.00-414.07) is provided to qualify its use. As allowed by ICD-9-CM Official Convention, 414.4 may be listed alone or as the secondary diagnosis code.
ICD-9-CM diagnosis code: 348.82 – Brain deathis a new five-digit code that has been added to the Other Disorders of the Central Nervous System (340-349) family of diagnosis codes. Previously, brain death had been reported using 348.89 – Other conditions of the brain according to the 2011 ICD-9-CM Index to Diseases. Now providers have a more accurate diagnosis code to report brain death when performing brain imaging procedures
Since these are brand new ICD9-CM diagnosis codes, providers should verify with payers that their systems have been updated and are capable of accepting them.
Files listing the new, deleted and revised ICD-9-CM diagnosis codes, which became effective October 1, 2011, may be found at the New, Deleted and Revised ICD-9-CM Codes – Summary Tables on the CMS website.
For a complete list of all current, Version 29 ICD-9-CM diagnosis codes, please download the Diagnosis and Procedure Codes: Abbreviated and Full Code Titles.
Related Reading: Readers may be interested in an article posted on the Society of Nuclear Medicine web site “SPN and MPN PET Medicare Coverage.”