tci Part B Insider - 2014 Issue 2

ICD-10: Prep Now for New Pneumonia Diagnosis Code

Starting this October, you’ll be required to report J18.9 for pneumonia. Although your Part B practice has grown accustomed to reporting a code from the 486 series for patients with pneumonia, that will change dramatically in October, when you’re required to start billing under the ICD-10 system. ICD-9 Coding Rules: Currently, the ICD-9-CM code set provides one diagnosis code for pneumonia caused by an unspecified organism: 486 (Pneumonia organism unspecified). Coding guidelines specify that diagnosis 486 excludes hypostatic or passive pneumonia, inhalation or aspiration pneumonia due to foreign materials, or pneumonitis due to fumes and vapors...

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