Health Information Management

ACDIS submits comments to CDC about proposed ICD-9-CM changes

HIM-HIPAA Insider, April 19, 2011

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The Association of Clinical Documentation Improvement Specialists (ACDIS) submitted comments March 29 to the Centers for Disease Control and Prevention (CDC) regarding proposed changes discussed during the March 9–10 ICD-9-CM Coordination & Maintenance committee meeting.

Regarding the causes of mild and moderate malnutrition, ACDIS questioned why underlying causes of malnutrition are ascribed only to severe malnutrition. ACDIS stated in its letter:
ACDIS believes that the fifth digits of the underlying cause of malnutrition used in category 262 should also be applied to category 260, 261, and 263 so that the data set differentiates the underlying causes of all variations of mild, moderate, and severe malnutrition. This is very important, given that the American Dieticians Association and the American Society for Parenteral and Enteral Nutrition will soon release their definitions of mild, moderate, and severe malnutrition syndromes and that those of us involved with clinical documentation and coding integrity wish to apply these definitions and their underlying causes uniformly.
The topic of acute kidney diseases and related disorders also triggered one of the more lively discussions at the ICD-9-CM Coordination & Maintenance committee meeting.
ACDIS submitted comments expressing its opposition to the National Kidney Foundation’s proposal to revise ICD-9-CM code 584 (acute kidney failure) to “acute kidney disease and disorders and acute tubular-interstitial diseases.” ACDIS instead recommended the following title revision:
584: Acute kidney injury
Includes: acute renal failure and acute kidney failure
In the letter, ACDIS also states it opposes the creation of proposed new codes 584.1 and 584.2:
The term acute kidney disease without acute kidney injury should not be introduced into this category because all the conditions described by the 584 code series represent acute kidney injury. Instead, we propose that category 584 (584.5 though 584.9) remain the same, with the proposed title change above, but that the series expand to include a fifth digit, as follows:
  • 584.x0, acute kidney injury (AKI) unspecified stage
  • 584.x1, AKI stage 1
  • 584.x2, AKI stage 2
  • 584.x3, AKI stage 3 
Click here to learn more about additional revisions ACDIS proposed for coding acute kidney diseases and related disorders.
ACDIS also submitted comments on:
  • Severely calcified coronary lesions
  • Hepatopulmonary syndrome
  • Infection following transfusion
  • Postoperative respiratory failure
  • Postoperative shock
  • Drug-induced pancytopenia
  • Hypertrophic cardiomyopathy
  • Acute interstitial pneumonitis
  • Atrial fibrillation and flutter
To learn more, access ACDIS’ comments in their entirety. You may also access audio recordings as well as the agenda and subsequent summary report of discussions from the meeting on the CMS website.
Editor’s note: Click here to learn more about ACDIS.This news article originally appeared in the April 13 issue of JustCoding.

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