ICD-9-CM 2012: 704.4x, 286.5x: Get Definite With Cyst, Hemorrhagic Disorder Coding

James Smith
December 20, 2011 — 1,234 views  
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Besides, 999.4x transforms 'shock' to 'reaction.'

In case your lab bills transfusion medicine services, pathology exams for definite cysts, or blood tests meant for hemorrhagic disorders, we have some news to get your 2012 ICD-9-CM coding in control.

Recognize Cyst Differences

ICD-9-CM 2012 creates two new codes for common hair-follicle cysts -- 704.41 (Pilar cyst) and 704.42 (Trichilemmal cyst). Pilar cysts are frequently confused with sebaceous cysts in spite of having individual characteristics.

For example: Pilar cysts form with keratinizing epithelium linked with a hair follicle. These cysts don't contain a granular layer, which is typical of sebaceous cysts.

The ICD-9-CM update will include an "excludes" statement for novel codes 704.41 as well as 704.42 under 706.2 (Sebaceous cyst).

Simplify Serum Reactions With New 999 Codes

In case you ever bill transfusion medicine codes (86850-86999), you can't afford to ignore ICD-9-CM revisions that will transform how you code serum reactions. The code update will nullify 999.4 (Anaphylactic shock due to serum) as well as 999.5 (Other serum reaction, not elsewhere classified) and substitute them with the following new codes:

  • 999.41 –- i.e. Anaphylactic reaction owing to administration of blood as well as blood products
  • 999.42 -- i.e. Vaccination
  • 999.49 -- i.e. Other serum
  • 999.51 -- i.e. further serum reaction owing to administration of blood as well as blood products
  • 999.52 -- i.e. vaccination
  • 999.59 -- i.e. further serum reaction

Differentiate anaphylaxis trigger: The present ICD-9-CM code 999.4 is not transfusion specific. Generating novel codes 999.41 and 999.42 will help differentiate anaphylaxis owing to transfusion or vaccination, for example ICD-9-CM 2012 offers related distinctions in new codes 999.5x.                                     

The new codes will perk up the accuracy of recording transfusion associated undesirable reactions and improve the capability to carry out active surveillance of transfusion safety.

An anaphylactic reaction is a kind of allergic hypersensitivity leading to symptoms like hives, wheezing, and perhaps a drop in blood pressure, which is anaphylactic shock. ICD-9-CM has used the phrase anaphylactic shock to comprise all anaphylactic reactions in the past, which lead to some perplexity among clinicians. That is the reason why ICD-9-CM 2012 modifies the terminology for 999.4x and additional codes for instance 995.0 (Other anaphylactic reaction) from "anaphylactic shock" to the broader term, "anaphylactic reaction."

Labs will also gain from a new "V" code that will help your anaphylaxis coding with V13.81 (Personal history of anaphylaxis). 

Look to New Lupus Code

You must plan for ICD-9-CM 2012 to get bigger existing four-digit code 286.5 (Hemorrhagic disorder due to intrinsic circulating anticoagulants) into a new variety of five-digit codes:

  • 286.52 -- i.e. Acquired hemophilia
  • 286.53 -- i.e. Antiphospholipid antibody by means of hemorrhagic disorder
  • 286.59 -- i.e. further hemorrhagic disorder owing to intrinsic circulating anticoagulants, antibodies, or inhibitors.



James Smith