Orthopedic coding is gearing up for some new ICD-9 additions: If your orthopedist treats children's arm problems on a regular basis, then you may make use of three new ICD-9 codes which are likely to get going with effect from October 1, 2009. Orthopedic coders, however, had hoped for a wider range of codes, says Leslie A. Follebout, CPC, COSC, PCS, coding manager at Peninsula Orthopaedic Associates in Salisbury, MD.
What's in and what's not: The addition of fifth digits to existing codes 274.0 Gouty arthropathy) and 453.8 (Other venous embolism and thrombosis of other specified veins) might not take place. However, some brand new additions could find mention.
Advantage: Most of the new codes will offer additional specificity to existing diseases, which can help you code more accurately.
What to look forward to?
If your orthopedist treats pediatric patients for fractures, then you're used to applying forearm fracture ICD-9 codes. These constitute nearly half of all childhood fractures. ICD-9 2010 may bring two new torus fracture options: 813.46 (Torus fracture of ulna [kalone]) and 813.47 (Torus fracture of radius and ulna).
"Torus" fractures, also called "buckle" fractures, are stable and non-displaced. What happens is the topmost layer of bone on one side is slightly compressed. Following the descriptors, you'll report 813.46 when the patient fractures only the ulna. When the patient fractures both, you'll use 813.47.
Word of caution: Don't confuse these codes with the existing torus fracture code 813.45 (Torus fracture of radius) and other radius and ulnar fracture codes specified in the 813.xx (Fracture of radius and ulna) range. Secondly, you'll need to know 832.2 (Nursemaid's elbow). Most likely, you will use 832.2 for pediatric patients between 1 and 3 years of age.
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