Code changes are not new to the coding world because diagnosis code changes are always updated and effective October 1 of each year (CPT code changes are always effective January 1). These dates should be embedded in the minds of rheumatologists and their staffs to avoid any backflow in payments and reimbursements for services provided. This is very important, because if a deleted code is billed on the HCFA 1500, payors will deny reimbursement for medical necessity.
For example, the 2011 code for spinal stenosis (lumbar region) has two new codes that include additional coding notes, detailed description, and associated index data:
2010 ICD-9 Code
- 724.01 Lumbar region
2011 ICD-9 Codes
- 724.01 Lumbar region, without neurogenic claudication
Lumbar region, NOS - 724.03 Lumbar region, with neurogenic claudication (new code for 2011)
Rheumatology practices can experience a flow of denials if this new code change is not billed correctly. Rheumatologists must use and document the most appropriate diagnosis and procedure code in patients’ medical records. Third-party payors and the Centers for Medicare and Medicaid Services no longer give a grace period to use new or revised codes.
Medical coding is an intricate part of your practice and has become more extensive through the years due to population growth and mortality data. It is vital that you keep abreast of the annual code changes and even more so with the new coding system that will arrive by early 2012!
For more information on ICD-10 coding, contact Antanya Chung at [email protected] or (404) 633-3777, ext. 818. For any other coding and billing information, contact Melesia Tillman, CPC, CHA, CRHC, at [email protected] or (404) 633-3777, ext. 820.
