APMA News - July/August 2012 - (Page 32)

Reimbursement By Lawrence A. Santi, DPM How to Code for a Painful Bunion Deformity Using ICD-10-CM The International Classification of Diseases, 10th Edition (ICD-10-CM) is scheduled to replace ICD-9-CM on October 1, 2014. The updated diagnostic coding system uses a completely new set of codes that requires much greater clinical details and specificity than ICD-9. To better understand the change, let’s take the example of a patient with a bunion and develop ICD10 diagnostic codes associated with this condition. A patient is referred to your office with a painful bunion on his left foot. The physical examination reveals bunion deformity, left foot. There is reduced range of motion, with the patient reporting discomfort with movement of the left first metatarsal-phalangeal joint. Review of the patient’s radiographs confirms the clinical findings along with mild–moderate degenerative changes in the left first metatarsal-phalangeal joint, which includes osteophytes dorsally at the left first metatarsal-phalangeal joint as well as subchondral bone cysts located at the head of the first metatarsal. Our tentative ICD-9 diagnoses, at this point, would include: 1. Bunion (727.1) 2. Hallux limitus (735.8) 3. Osteoarthritis, localized, foot (715.17) 4. Pain (729.5) or Pain in Joint (719.47) The steps for determining the correct diagnostic code under ICD-10 are, fortunately, the same as used in ICD-9. If you have a draft copy of ICD-10 (available at www.cdc.gov/nchs/icd/ icd10cm.htm#10update), go to ICD-10-CM Index to Diseases and Injuries (Volume 2) to begin looking up the diagnosis. ICD-10-CM Tabular List M20.1- [hallux valgus (acquired); bunion] You will see a notation that a fifth character is needed. - M20.12 [hallux valgus (acquired), left foot] Your ICD-10 diagnostic code for left bunion deformity is M20.12. Hallux Limitus Steps: ICD-10-CM Index H Hallux - limitus M20.5xThe hyphen at the end of M20.5x indicates that additional character(s) are needed. ICD-10-CM includes the “x” character as a placeholder within certain codes to allow for future expansion. If a placeholder “x” is found within a code, the “x” must be included in that code for it to be valid. Go to the ICD-10-CM Tabular List of Diseases and Injuries (Volume 1) for the most specific diagnosis. ICD-10-CM Tabular List M20.5x [Other deformities of toe(s) (acquired)] You will see a notation that a sixth character is needed. - M20.5x2 [Other deformities of toe(s) (acquired), left foot] Your ICD-10 diagnostic code for left hallux limitus is M20.5x2. Bunion Steps: ICD-10-CM Index B Bunion - see Deformity, toe, hallux valgus D Deformity - toe (acquired) - hallux valgus M20.1The hyphen at the end of M20.1 indicates that additional character(s) are needed. Now that you have the index code recommendation for hallux valgus (i.e., bunion), albeit with a hyphen at the end, you need to go to ICD-10-CM Tabular List of Diseases and Injuries (Volume 1) for the most specific diagnosis. 32 APMA News July/August 2012 Osteoarthritis, Localized, Foot Steps: ICD-10-CM Index O Osteoarthritis - foot joint M19.07The hyphen at the end of M19.07 indicates that additional character(s) are needed. http://www.cdc.gov/nchs/icd/icd10cm.htm#10update http://www.cdc.gov/nchs/icd/icd10cm.htm#10update

Table of Contents for the Digital Edition of APMA News - July/August 2012

APMA News - July/August 2012
President’s Message
Contents
Innovative, Intuitive, Inventive
Health Policy & Practice Committees Meet to Address Issues Facing Podiatrists
MPMA Instrumental in Uncovering Health-care Fraud
Does the Media Still Matter?
Introducing APMA’s ACO Workgroup
APMA By the Decade
The US House of Representatives Recognizes APMA’s 100th Anniversary
2011 Podiatric Practice Survey
Profiles in Progress
Reimbursement
Federal Advocacy Forum
List of Cosponsors to the Equity and Access for Podiatric Physicians Under Medicaid Act
APMAPAC Chair Report
IT Consultant
Technofile
Get 2012 Annual Scientific Meeting Coverage
Annual Scientific Meeting Preliminary Program
Annual Scientific Meeting Sponsors
Annual Scientific Meeting Registration Form
APMA All Stars
In Short
CPME Invitation for Comments
Worthy of Note
Call for Committee Nominations
Affiliates Corner
List of Affiliated Organizations
Insurance Advisor
Bylaws Propositions Due
New Members
Death Notices
APMAPAC Update
Development Update
Classified Advertising
Dates to Remember
Advertising Index
10 Questions
Your APMA
100th Anniversary Commemorative Section

APMA News - July/August 2012