ICD-9 2010: More Coding Options for Brain Injury

CT scan: Subdural haemorrhage caused by trauma

Check out V80.01 and V80.09 for special screenings.

The newest edition of ICD-9 changes goes into effect Oct. 1, so adjust your system to reflect some new diagnosis codes for special neurological screenings — and one that’s about to become invalid — to be sure your claims stay on par.

Extend ‘Other Conditions’ Dx From 348.8 to 348.89

Diagnosis 348.8 (Other conditions of brain) will be invalid starting Oct. 1, but ICD-9 2010 introduces a new fifth-digit replacement: 348.89. The descriptor remains the same, so you’ll be able to use it for the same circumstances as 348.8.

“I seldom used 348.8 because I do mostly surgery coding and use the final pathology report for diagnoses,” says Kathryn Gemmell, RHIT, in the physician coding department of Luke’s Hospital in Bethlehem, Pa. “Something like calcium deposits on the brain or brain death could be coded to 348.89.” You might also turn to 348.89 to show a brain problem not identified with a specific ICD-9 code, Gemmell adds.

“I used the 348.8 often when there is ‘something’ found, but it’s not yet defined as a neoplastic process or other definitive process,” adds Lisa Nelson, CPC, a medical coding specialist in Wisconsin. Nelson says you might also have used 348.8 when the physician used verbiage such as “brain lesion” or “mass” prior to pathological diagnosis.

Check New Alternatives to V80.0

Coders previously reported V80.0 (Special screening for neurological, eye, and ear diseases; neurological conditions) along with the patient’s symptoms prior to an MRI, MRA, or other test to confirm a definitive diagnosis, such as 780.4 (Dizziness and giddiness) or 784.0 (Headache).

New approach: V80.0 will be invalid when the new ICD-9 codes go into effect. Instead, you’ll choose from two new options that expand the diagnosis category:

• V80.01 — Special screening for traumatic brain injury

• V80.09 — Special screening for other neurological conditions.

The old V80.0 was a fairly broad catch-all code for many conditions, so coders often found themselves relying on it.

“I usually code symptoms with V80.0 if there are any available to report, or if the patient has symptoms that might not make sense for a neurosurgeon, I use them along with the V80.0,” Nelson says. She often paired V80.0 with the appropriate findings when her physician ordered tests with odd or unspecified symptoms, such as tremor (781.0, Abnormal involuntary movements), numbness (782.0, Disturbance of skin sensation), or abnormality of gait (781.2).

The replacements of V80.01 and V80.09 help you tighten your reporting because they differentiate between screenings for brain injury and other neurological conditions. Coders from a range of specialties — including radiology, neurology, family practice, sleep centers, and more — could find themselves relying on the new options, Gemmell says.

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