Q: I was told that the ICD-9 codes changed on Oct. 1, 2006, meaning the codes I use may be invalid and I could have claims denied. Is this all true?
A: Yes, technically the codes do change and update for the following year on Oct. 1 of the year prior. However, the changes are seldom of any major consequence. In many instances, the changes are simply additions or revisions to the definition of the code for clarification purposes. Furthermore, a change will be reported even if a comma or period is changed to a semicolon, as it will be classified as a revision.
Have no fear that the current codes commonly used for chiropractic-related diagnosis have been changed; therefore, your ability to accurately code should not be affected, nor should your ability to receive reimbursement for your services. Technically, for 2007, there will be 295 total code updates. Of those 295 updates, 211 codes have been added, 29 have been deleted and 55 have been revised.
Highlights of the changes for 2007 that would be of interest to chiropractic doctors are:
338.0 Central pain syndrome
338.11 Acute pain due to trauma
338.19 Other acute pain
338.21 Chronic pain due to trauma
338.29 Other chronic pain
338.4 Chronic pain syndrome (associated with significant psychosocial dysfunction)
780.6 Generalized pain (not otherwise specified)
729.71 Non-traumatic compartment syndrome of upper extremity
729.72 Non-traumatic compartment syndrome of lower extremity
958.90 Traumatic compartment syndrome, unspecified
958.91 Traumatic compartment syndrome of upper extremity
958.92 Traumatic compartment syndrome of lower extremity
While these codes technically are in effect now, I would not begin using them until Jan. 1, 2007 - and even then, do not be surprised if, the first few times you use them, the carrier does not recognize them; the data systems may not have been updated. Of interesting note to me is the ability for an insurance carrier to immediately make changes when it is in their favor, but somehow lag when it is the opposite.
If you need an update to your coding book (I do recommend you update annually), the ICD-9 code book can be purchased from most medical book resellers, as well as through your state chiropractic association or the American Chiropractic Association. If you would like a list of common diagnosis codes (I do not attest that it is comprehensive, but merely a "common" code list), e-mail a request in that regard to sam@hjrossnetwork.com.
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