ICD-9 Changes for 2006
Julie A. Leu, CPC
Billing Compliance Coordinator
September 27, 2005
Changes to ICD-9 for 2006



Effective October 1, 2005
ICD-10 still “in the wings”
Updates are available at:
• http://www.IngenixOnline.com
• http://www.cdc.gov/nchs/datawh/ftp
serv/ftpicd9/ftpicd9.htm
Summary of Changes for 2006
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173 New diagnosis codes
14 New category or subcategory
titles
28 Revised diagnosis code titles
April 2005 revisions to Guidelines
have been incorporated.
Summary of Changes to the
Coding Guidelines
 Conventions, general coding
guidelines and chapter-specific
guidelines
 Addition of V Code Table
• Principal or first listed
• First or additional
• Additional only
Changes to ICD-9 for 2006
 New Code
• 259.5 Androgen insensitivity
syndrome
 276.5 (Volume depletion) has
been expanded to require a 5th
digit:
• 276.50
• 276.51
• 276.52
Volume depletion, unspecified
Dehydration
Hypovolemia
Changes to ICD-9 for 2006
 New Code
• 278.02 Overweight
 287.3 has been expanded to 5th digit
• 287.30 Primary thrombocytopenia,
unspecified
• 287.31 Immune thrombocytopenic purpura
• 287.32 Evans’ syndrome
• 287.33 Congenital and hereditary
thrombocytopenic purpura
• 287.39 Other primary thrombocytopenia
Changes to ICD-9 for 2006

New Codes
• 291.82 Alcohol induced sleep
disorders
• 292.85 Drug induced sleep
disorders

New Category, subcategories, and
codes for Organic sleep disorder
New Category: Organic Sleep
Disorders
• 327.0 Organic disorders of initiating
and maintaining sleep (Organic
insomnia)
• 327.00 Organic insomnia, unspecified
• 327.01 Insomnia due to medical
condition classified elsewhere
• 327.02 Insomnia due to mental disorder
• 327.09 Other organic insomnia
New Subcategory Under Organic
Sleep Disorders
•
327.1 Organic disorders of excessive
somnolence
•
•
•
•
•
•
327.10 Organic hypersomnia, unspecified
327.11 Idiopathic hypersomnia with long
sleep time
327.12 Idiopathic hypersomnia without
long sleep time
327.14 Hypersomnia due to medical
condition classified elsewhere
327.15 Hypersomnia due to mental
disorder
327.19 Other organic hypersomnia
New Subcategory Under Organic
Sleep Disorders
•
327.2
•
•
•
•
•
Organic sleep apnea
327.20 Organic sleep apnea,
unspecified
327.21 Primary central sleep apnea
327.22 High altitude periodic breathing
327.23 Obstructive sleep apnea (adult)
(pediatric)
327.24 Idiopathic sleep related
nonobstructive alveolar hypoventilation
New Subcategory Under Organic
Sleep Disorders
•
327.2
•
•
•
•
Organic sleep apnea, con’t.
327.25 Congenital central alveolar
hypoventilation syndrome
327.26 Sleep related hypoventilation/
hypoxemia in conditions classified
elsewhere
327.27 Central sleep apnea in
conditions classified elsewhere
327.29 Other organic sleep apnea
New Subcategory Under Organic
Sleep Disorders
•
327.3 Circadian rhythm sleep disorder
•
•
•
•
327.30 Circadian rhythm sleep
unspecified
327.31 Circadian rhythm sleep
delayed sleep phase type
327.32 Circadian rhythm sleep
advanced sleep phase type
327.33 Circadian rhythm sleep
irregular sleep-wake type
disorder,
disorder,
disorder,
disorder,
New Subcategory Under Organic
Sleep Disorders
•
327.3 Circadian rhythm sleep disorder,con’t
•
•
•
•
•
327.34 Circadian rhythm sleep
free-running type
327.35 Circadian rhythm sleep
lag type
327.36 Circadian rhythm sleep
work type
327.37 Circadian rhythm sleep
conditions classified elsewhere
327.39 Other circadian rhythm
disorder
disorder,
disorder, jet
disorder, shift
disorder in
sleep
New Subcategory Under Organic
Sleep Disorders
•
327.4 Organic parasomnia
•
•
•
•
•
327.40 Organic parasomnia, unspecified
327.41 Confusional arousals
327.42 REM sleep behavior disorder
327.43 Recurrent isolated sleep paralysis
327.44 Parasomnia in conditions
classified elsewhere
• 327.49 Other organic parasomnia
New Subcategory Under Organic
Sleep Disorders
•
327.5 Organic sleep related
movement disorders
• 327.51 Periodic limb movement
disorder
• 327.52 Sleep related leg cramps
• 327.53 Sleep related bruxism
• 327.59 Other organic sleep related
movement disorders
• 327.8 Other organic sleep disorders
New Codes in Diabetic Retinopathy
Subcategory
•
•
•
•
•
362.03 Nonproliferative diabetic
retinopathy NOS
362.04 Mild nonproliferative diabetic
retinopathy
362.05 Moderate nonproliferative diabetic
retinopathy
362.06 Severe nonproliferative diabetic
retinopathy
362.07 Diabetic macular edema
Instructional note added
Changes to ICD-9 for 2006
▲Change
in nomenclature
throughout the 403 and 404
sections.
▲“renal” disease changed to
“kidney” disease”
▲“renal failure” changed to
“chronic kidney disease”
Changes to ICD-9 for 2006
• New Codes:
• 426.82 Long QT
syndrome
• 443.82
Erythromelalgia
Changes to ICD-9 for 2006
• New Subcategory: 525.4
Complete edentulism
• 525.40 Complete
unspecified
• 525.41 Complete
• 525.42 Complete
• 525.43 Complete
• 525.44 Complete
edentulism,
edentulism,
edentulism,
edentulism,
edentulism,
class
class
class
class
I
II
III
IV
Changes to ICD-9 for 2006
• New Subcategory: 525.5 Partial
edentulism
• 525.50
• 525.51
• 525.52
• 525.53
• 525.54
Partial
Partial
Partial
Partial
Partial
edentulism,
edentulism,
edentulism,
edentulism,
edentulism,
unspecified
class I
class II
class III
class IV
Changes to ICD-9 for 2006
▲567.2 Other suppurative peritonitis,
has been expanded to require a fifth
digit:
• 567.21 Peritonitis (acute) generalized
• 567.22 Peritoneal abscess
• 567.23 Spontaneous bacterial
peritonitis
• 567.29 Other suppurative peritonitis
Changes to ICD-9 for 2006
▲567.3 Retroperitoneal infections, has
been expanded to require a fifth
digit:
• 567.31 Psoas muscle abscess
• 567.38 Other retroperitoneal abscess
• 567.39 Other retroperitoneal infections
Changes to ICD-9 for 2006
▲567.8 Other specified retroperitonitis,
has been expanded to require a fifth
digit:
• 567.81 Choleperitonitis
• 567.82 Sclerosing mesenteritis
• 567.89 Other specified peritonitis
Changes to ICD-9 for 2006
▲ 585
Revised from “Chronic renal
failure” to “Chronic kidney disease”
and has been expanded to require a
forth digit:
• 585.1 Chronic kidney disease, Stage I
•
585.2 Chronic kidney disease, Stage II
(mild)
• 585.3 Chronic kidney disease, Stage III
(moderate)
Changes to ICD-9 for 2006
▲ 585
Revised from “Chronic renal
failure” to “Chronic kidney disease”
and has been expanded to require a
fourth digit:
• 585.4 Chronic kidney disease, Stage IV
(severe)
• 585.5 Chronic kidney disease, Stage V
• 585.6 End stage renal disease
• 585.9 Chronic kidney disease,
unspecified
Changes to ICD-9 for 2006
▲ 599.6
“Urinary obstruction” has
been expanded to require a fifth
digit:
• 599.60 Urinary obstruction, unspecified
• 599.69 Urinary obstruction, not
otherwise specified
Changes to ICD-9 for 2006
▲ 651.7
“Multiple gestation following
(elective) fetal reduction” has been
expanded to require a fifth digit:
• 651.70 Multiple gestation . . . unspecified
as to episode of care or not applicable
• 651.71 Multiple gestation . . . delivered,
with or without mention of antepartum
condition
• 651.73 Multiple gestation . . .
antepartum condition or complication
Changes to ICD-9 for 2006
New Codes:
• 760.77 Noxious influences affecting fetus
or newborn via placenta or breast milk,
Anticonvulsants
• 760.78 Noxious influences affecting fetus
or newborn via placenta or breast milk,
Antimetabolic agents
• 763.84 Meconium passage during delivery
Changes to ICD-9 for 2006
▲ 770.1
Revised from “Meconium
aspiration syndrome” to “Fetal and
newborn aspiration” and has been
expanded to require a fifth digit:
• 770.10 Fetal and newborn aspiration, unspecified
• 770.11 Meconium aspiration without respiratory
symptoms
• 770.12 Meconium aspiration with respiratory
symptoms
• 770.13 Aspiration of clear amniotic fluid without
respiratory symptoms
Changes to ICD-9 for 2006
• 770.14 Aspiration of clear amniotic
fluid with respiratory symptoms
• 770.15 Aspiration of blood without
respiratory symptoms
• 770.16 Aspiration of blood with
respiratory symptoms
• 770.17 Other fetal and newborn
aspiration without respiratory
symptoms
Changes to ICD-9 for 2006
• 770.18 Other fetal and newborn
aspiration with respiratory
symptoms
• 770.85 Aspiration of postnatal
stomach contents without
respiratory symptoms
• 770.86 Aspiration of postnatal
stomach contents with respiratory
symptoms
• 779.84 Meconium staining
Changes to ICD-9 for 2006
▲In addition to codes in the 327.XX
classification, codes in the 780.5
subclassification for signs and symptoms
of insomnia have been changed in their
description.
! Correction: Code 780.50 was mistakenly
omitted from ICD-9 for 2006. It is a
valid code and reports:
“Sleep disturbance, unspecified”
• 780.95 Other excessive crying
Changes to ICD-9 for 2006
▲ 799.0
Subcategory descriptor
revised to “Asphyxia and hypoxemia”
and has been expanded to require a
fifth digit:
• 799.01 Asphyxia
• 799.02 Hypoxemia
Changes to ICD-9 for 2006
▲ 996.4
“Mechanical complication of
internal orthopedic device, implant,
and graft” has been expanded to
require a fifth digit:
• 996.40 Unspecified complication . . .
• 996.41 Mechanical loosening of prosthetic
joint
• 996.42 Dislocation of prosthetic joint
• 996.43 Prosthetic joint implant failure
Changes to ICD-9 for 2006
• 996.44 Peri-prosthetic fracture around
prosthetic joint
• 996.45 Peri-prosthetic osteolysis
• 996.46 Articular bearing surface wear of
prosthetic joint
• 996.47 Other mechanical complication of
prosthetic joint implant
• 996.49 Other mechanical complication of
other internal orthopedic device, implant, and
graft
Changes to ICD-9 for 2006
V Code Changes
•
V12.42 Personal history of Infections
of the central nervous system
• V12.60 Personal history of Unspecified
disease of respiratory system
• V12.61 Personal history of Pneumonia
(recurrent)
• V12.69 Personal history of Other
diseases of respiratory system
Changes to ICD-9 for 2006
V Code Changes
• V13.02 Personal history of Urinary (tract)
infection
• V13.03 Personal history of nephrotic
syndrome
• V15.88 Personal history of, History of fall
• V17.81 Family history of, Osteoporosis
• V17.89 Family history of, Other
musculoskeletal diseases
• V18.9 Family history of, Genetic disease
carrier
Changes to ICD-9 for 2006
V Code Changes
• V26.31 Testing for genetic disease
carrier status
• V26.32 Other genetic testing
• V26.33 Genetic counseling
• V46.13 Encounter for weaning from
respirator [ventilator]
• V46.14 Mechanical complication of
respirator [ventilator]
Changes to ICD-9 for 2006
V Code Changes
• V49.84 Bed confinement status
▲V58.1 subcategory descriptor
revised and expanded to require a
fifth digit:
• V58.11 Encounter for antineoplastic
chemotherapy
• V58.12 Encounter for antineoplastic
immunotherapy
Changes to ICD-9 for 2006
V Code Changes
• New subcategory requiring fifth digit,
V59.7 Donors, Egg (oocyte) (ovum)
• V59.70 Egg . . . Donor, unspecified
• V59.71 Egg . . . Donor,
anonymous recipient
• V59.72 Egg . . . Donor,
designated recipient
• V59.73 Egg . . . Donor,
anonymous recipient
• V59.74 Egg . . . Donor,
designated recipient
under age 35,
under age 35,
age 35 and over,
age 35 and over,
Changes to ICD-9 for 2006
V Code Changes
• V62.84 Suicidal ideation
• V64.0 subcategory descriptor revised and
expanded to require a fifth digit, Vaccination
not carried out . . .
•
•
•
•
V64.00 . .
V64.01 . .
V64.02 . .
condition”
V64.03 . .
state”
. unspecified reason”
. because of acute illness”
. because of chronic illness or
. because of immune compromised
Changes to ICD-9 for 2006
V Code Changes
▲ V64.0 subcategory descriptor revised and
expanded to require a fifth digit, “Vaccination
not carried out . . .
•
•
•
•
•
•
V64.04 . . . because of allergy to vaccine or
component”
V64.05 . . . because of caregiver refusal”
V64.06 . . . because of patient refusal”
V64.07 . . . for religious reasons”
V64.08 . . . because patient had disease being
vaccinated against”
V64.09 . . . for other reason”
Changes to ICD-9 for 2006
V Code Changes
• V69.5 Behavioral
insomnia of childhood
• V72.4 Pregnancy
examination or test,
positive result
• V72.86 Encounter for
blood typing
Changes to ICD-9 for 2006
V Code Changes
• New V Code category to report
Body Mass Index
• V85.0 Body Mass Index
• V85.0 through V85.4 vary from four
digit to five digit codes and report BMI
from 19 to 40 and over, adult
Thank you!