Health Information Management

Healthcare News: CMS and NCHS release new ICD-9 coding guidelines effective October 1

JustCoding News: Outpatient, September 8, 2009

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On August 31, CMS and the National Center for Health Statistics (NCHS) released the new ICD-9-CM Official Guidelines for Coding and Reporting, which take effect October 1.

These guidelines accompany and complement the official conventions and instructions provided within the ICD-9-CM itself.

Overall, changes in the new guidelines are minimal. Revisions include activity code guidelines for code range E001–E030, which are used to indicate the activity that caused or contributed to an injury or other health condition.

The guidelines state the following:

Unlike other E codes, activity E codes may be assigned to indicate a health condition (not just injuries) resulted from an activity, or the activity contributed to the condition. The activity codes are not applicable to poisonings, adverse effects, misadventures or late effects.

Revisions also include new guidelines for external status codes (category E000), which state the following:

A code from category E000, External cause status, should be assigned whenever any other E code is assigned for an encounter, including an Activity E code, except for the events noted below. Assign a code from category E000, External cause status, to indicate the work status of the person at the time the event occurred. The status code indicates whether the event occurred during military activity, whether a non-military person was at work, whether an individual including a student or volunteer was involved in a non-work activity at the time of the causal event.

A code from E000, External cause status, should be assigned, when applicable, with other external cause codes, such as transport accidents and falls. The external cause status codes are not applicable to poisonings, adverse effects, misadventures or late effects.

Do not assign a code from category E000 if no other E codes (cause, activity) are applicable for the encounter.

Do not assign code E000.9, Unspecified external cause status, if the status is not stated.

The new guidelines also include instructions related to the following:

  • Puerperal sepsis
  • Anemia due to antineoplastic chemotherapy
  • Anemia in neoplastic disease
  • Antineoplastic chemotherapy induced anemia

Editor’s note: To learn more about the new ICD-9 codes, purchase a copy of HCPro’s August 26 audio conference “The Impact of the New and Revised 2010 ICD-9-CM Codes.”



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