Unless some kind of unexpected zero hour delay occurs between now and the October 1 deadline, ICD-10 is coming to a Plastic Surgery practice near you (in fact, it’s coming to your Plastic Surgery practice).
It’s the Final Countdown, people!
Somebody cue me up a 1980s-style “get ready” montage!
On this blog, we’ve done our best over the last nine months or so to give our readers as many resources as possible to get prepared for the switch to ICD-10 in advance. In fact, back in February I provided our readers with a three-part blog series that provided a detailed look at how some of the more commonly used ICD-9 codes in Dermatology, Ophthalmology, and Plastic Surgery would translate over to ICD-10. For those who might be in need of a little extra help in making the ICD-10 transition, I also wrote a blog post in March about the benefits of having Nextech’s intuitive ICD-10 solution—NexCode.
Seeing as how we are so close to the transition, we figured it might be a good idea to give readers one last refresher lesson. Therefore, in this three-part series, we will take a look at five rather common ICD-9-CM codes for each of three distinct specialties—Plastic Surgery, Dermatology, and Ophthalmology—and compare them to their respective ICD-10-CM counterparts.
ICD-10-CM Codes in Plastic Surgery
In this first part of the series, we will be discussing five common codes specific to Plastic Surgery (followed by Dermatology in Part 2 and Ophthalmology in Part 3) in the soon-to-be phased out ICD-9-CM system. Then we will look at how these codes should be translated into the more specific ICD-10-CM coding language.
Let’s start with something fairly simple—Macrogenia
In ICD-9-CM, this would fall under 524.05 (524 being the general category for “dentofacial anomalies, including malocclusion,” and .05 to denote “major anomalies of jaw sixe, macrogenia”). In ICD-10-CM, macrogenia would be coded in the following manner:
Primary category: M (00-99, for diseases of the musculoskeletal system and connective tissue)
2-digit category: 26 (dentofacial anomalies)
This means the primary code for this in ICD-10-CM would be M26, which must now be further specified by type (macrogenia) to create a diagnosis code:
M26.0: Major anomalies of jaw size
However, the above code is not yet a billable code. In order to create a billable code, it must be further specified:
M26.05: Macrogenia
Let’s try another one—Rhinophyma
In ICD-9-CM, this would fall under 695.3 (695 being the general category for “erythematous conditions,” and .3 to denote only “rosacea”). This is a fairly umbrella-matured code, since it includes the condition as well as all related symptoms without further specification. However, in ICD-10-CM, Rhinophyma would be coded in the following manner:
Primary category: L (60-75, for disorders of skin appendages)
2-digit category: 71 (rosacea)
This means the primary code for this in ICD-10-CM would be L71, which must now be further specified according to the related symptom/condition (Rhinophyma) to create a final diagnosis code:
L71.1: Rhinophyma
For our third example, let’s look at something a bit more complex—dermatochalasis
In ICD-9-CM, this would fall under 374.87 (374 being the general category for “other disorders of the eyelids,” and .87 to denote “dermatochalasis”). This is a bit vague, since it does not specify location. In ICD-10-CM, dermatochalasis would be coded in the following manner:
Primary category: H (00-05, for disorders of the eyelid, lacrimal system and orbit)
2-digit category: 02 (other disorders of the eyelid)
This means the primary code for this in ICD-10-CM would be H02, which must now be further specified according to type (dermatochalasis) and location to create a diagnosis code:
H02.83: dermatochalasis of the eyelid
However, the above code is not specific on location, and therefore it is not yet a billable code. In order to create a billable code, it must be further specified from the following potential options based on location:
H02.831: dermatochalasis of right upper eyelid
H02.832: dermatochalasis of right lower eyelid
H02.833: dermatochalasis of right eye, unspecified eyelid
H02.834: dermatochalasis of left upper eyelid
H02.835: dermatochalasis of left lower eyelid
H02.836: dermatochalasis of left eye, unspecified eyelid
H02.839: dermatochalasis of unspecified eye, unspecified eyelid
Keep in mind that H02.839 may not be considered an acceptable billable code in some circumstances. Remember that, when it comes to ICD-10-CM, it’s always best to use a code that is as specific as possible in order to avoid billing/claim rejections.
RELATED: Delays in ICD-10 code processing for Medicaid programs in four states
Our fourth example will be something fairly more routine—adiposity, localized
In ICD-9-CM, this would fall under 278.1 (278 being the general category for “overweight, obesity and other hyperalimentation,” and .1 to denote “localized adiposity”). In ICD-10-CM, localized adiposity would be coded in the following manner:
Primary category: E (65-68, for overweight, obesity and other hyperalimentation)
2-digit category: 65 (localized adiposity)
So the primary code for this would be E65. Oddly, this seems to be one of those few codes that has not yet been expanded into decimal/specification codes. However, it has been deemed applicable to the following list of description symptoms:
- Adiposity, localized
- Excess subcutaneous fat of back
- Excess subcutaneous fat of breast
- Excess subcutaneous fat of lower limb
- Excess subcutaneous fat of upper limb
- Localized obesity
- Panniculus of abdomen
- Panniculus of arm
- Panniculus of back
- Panniculus of breast
- Panniculus of leg
- Pannus, abdominal
- Tissue excess, arm panniculus
- Tissue excess, back panniculus
- Tissue excess, breast panniculus
- Tissue excess, leg panniculus
For our fifth and final step-by-step example, let’s look at another one that’s a bit complicated—acquired deformity of the auricle or pinna
In ICD-9-CM, this would fall under 380.32 (380 being the general category for “disorders of the external ear,” and .32 to denote “acquired deformities of the auricle or pinna”). This is a bit vague, since it does not specify location. In ICD-10-CM, dermatochalasis would be coded in the following manner:
Primary category: H (60-62, for disorders of the external ear)
2-digit category: 61 (other disorders of the external ear)
This means the primary code for this in ICD-10-CM would be H61, which must now be further specified according to type (dermatochalasis) and location to create a diagnosis code:
H61.11: acquired deformity of pinna
However, the above code does not specify a location, and therefore it is not yet a billable code. In order to create a billable code, it must be further specified from the following potential options based on location:
H61.111: acquired deformity of pinna, right ear
H61.112: acquired deformity of pinna, left ear
H61.113: acquired deformity of pinna, bilateral
H61.119: acquired deformity of pinna, unspecified ear
Keep in mind that H61.119 may not be considered an acceptable billable code in some circumstances. As mentioned earlier, it’s always best to use a code that is as specific as possible in order to avoid billing/claim rejections when using ICD-10-CM.
I hope this article has been helpful for those of you in the Plastic Surgery specialty, giving you a bit more insight into the fast approaching final transition from ICD-9 to ICD-10. For those of you in Dermatology, we will be getting to you in Part 2 of this blog series (Ophthalmologists, we’ll be talking to you folks in Part 3).
ICD-10 is upon us, ladies and gentlemen… it’s time to suit up.
Thanks for reading!
