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Recent ICD – 10 Changes in Nephrology, Cardiology and Pediatrics Medical Billing

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A Big Change – ICD-10 in Nephrology, Cardiology and Pediatrics Medical Billing

Nephrology, along with cardiology and, pediatrics will be tougher smash than other specialties during the ICD-10 transition. The National Kidney Foundation states that 26 million adults have chronic kidney disease (CKD).   Nephrology will see significant changes to coding; Errors in application of new coding can impact the billing of your patients.  Take steps to learn the coding and prepare for a smoother transition.

New Coding for Your Nephrology Practice

New multiple ICD-10 codes make it all more necessary for the staff’s to educate early in order to avoid billing complications.

Some of the highlights include:

  1. Various codes required for coding diabetic CKD. ICD-9 has a single code for diabetes but the ICD-10 has 5 codes.  One references the stage of CKD and the other is indicative of the form of diabetes with CKD.  ICD – 250.40, Diabetes type 2 or unspecified with renal manifestation not stated as uncontrolled will be coded as E11.22, Diabetes type 2 with diabetic chronic kidney diseases and N18.1-N18.6, CKD stage, or E11.29, Diabetes with other diabetic kidney complication (renal tubular degeneration).
  2. Hypertensive CKD takes two codes in ICD-10. The first code is to indicate that the patient exhibits hypertension and CKD, the second code is for the level of CKD.
  3. Hypertension coding decreases. I10, essential (primary hypertension), the new coding under ICD-10, denotes for 401.0, malignant essential hypertension, 401.1, benign essential hypertension, and 401.2, unspecified essential hypertension. The same type of pattern occurs with 403.00, 403.10, and 403.90 which fall under I12.9.  Also 403.01, 403.11 and 403.91 become I12.0.
  4. CKD codes have a single code in reference to their stage. For example, chronic kidney stage III, originally coded as 585.3, becomes N18.3 in ICD-10.  Codes begin with a letter, except for U, followed by three to up to seven digits. There are exceptions to this application in ICD-10 coding as in the coding for chronic gout, M1a.
  5. ESRD coding is a direct one-to-one conversion, as well as acute renal failure coding. Other common condition coding changes include over fluid overload, edema, and hyperlipidemia other and unspecified.

Justin Derkack, ICD-10 Coding project manager at Bristol Healthcare Services, recommends that practices give themselves generous time to make the transition to ICD-10.   “It takes time to start rolling out the effort. If you wait too long, the ramp up time will be tremendously difficult.  You need to get lots of people on the same page and that doesn’t happen overnight.”

Postponing ICD-10 Transition Could Cost Your Practice Lot of Money!

All of the changes that influence Nephrology coding in ICD-10 make it commanding that providers take the time to guarantee that all required staff are competently trained and that the internal systems in place can submit the new coding and manage their medical billing efficiently.