Pediatric coding: Stay tuned to ICD-9 2010 changes

ICD-9 codes have gone into effect effective October 1, 2009. So if you stick to the earlier ICD-9 codes to describe a colicky newborn, who’s irritable and has not regained his birth weight, will result in three incorrect diagnosis entries and a truncated code denial.

Here’s what you need to know to keep yourself on track:

5th digit to your feeding problems’ code

When insurers start to require ICD-9 2010 diagnoses, you may see denials on your newborn follow-up visits if you use “feeding difficulties” code 779.3 (Feeding problems in newborn). As per the new changes, this code will require a fifth-digit “1”.

2nd ‘Failure to Thrive’ Entry

When the newborn is one week old and hasn’t reached his birth weight by then, you might also code “Failure to thrive”. The coder may code 783.41 for “Failure to Thrive”, but the code is designated as a pediatric and not a newborn code.

ICD-9 2010 comes to your rescue with a new code – 779.34 – Failure to thrive, newborn.

ICD-9 vomiting listings expand

ICD-9 2010 has expanded vomiting codes. If you thought 787.07 applies across the board, think again. You can now specify bilious vomiting (779.32, Bilious vomiting in newborn and other vomiting (779.33, other vomiting in newborn).

Colic has its own code now

The pediatric community can smile away as the creation of 789.7 will not lump colic in with generalized abdominal pain.

New codes to represent irritability and nervousness

ICD-9 2010 brings with it new codes to better represent irritability and nervousness. 799.2 , the current code of nervousness, will cease to exist. The new codes are 799.21 (nervousness), 799.22 (irritability), and 799.23 (impulsiveness).

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