The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), parts of the Department of Health and Human Services (DHHS), have updated their guidelines effective November 15, 2006. Used by all providers, the new guidelines allow appropriate and uniform code selection when reporting procedures performed in accordance with the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM).

Recent changes help clarify, simplify, and permit more specific diagnosis codes to better reflect the complexity of your services.

This revision updates sections on pain management and pathologic and traumatic fractures.

Earlier updated sections on the diagnosis coding for patients with diabetes mellitus, cerebral infarction/CVA, and chronic obstructive pulmonary disease (COPD) should be reviewed.

Your referring physicians may need to be informed to obtain this additional information, including the type of diabetes.  For example, a fifth digit is required for all category 250 series codes.  Coders must know if the diabetes is controlled or uncontrolled.  The coding for COPD was made clearer.  It directs you to select the most severe condition type, and encourages the use of the patient's chronic condition, such as bronchitis, emphysema, or asthma.  When no specifics are available it designates code 496, chronic airway obstruction.

Narrative changes appear in bold text.  Items underlined have been moved within the guidelines since December 2005.  These updated guidelines include the updated V Code Table.

More details can be found in the revised guidelines located at: