ICD-9 Changes for 2006 Julie A. Leu, CPC Billing Compliance Coordinator September 27, 2005.

ICD-9 Changes for 2006ICD-9 Changes for 2006

Julie A. Leu, CPCBilling Compliance Coordinator

September 27, 2005

Changes to ICD-9 for 2006Changes to ICD-9 for 2006

Effective October 1, 2005Effective October 1, 2005 ICD-10 still “in the wings”ICD-10 still “in the wings” Updates are available at:Updates are available at:

• http://www.IngenixOnline.comhttp://www.IngenixOnline.com• http://http://www.cdc.gov/nchs/datawh/ftpwww.cdc.gov/nchs/datawh/ftp

serv/ftpicd9/ftpicd9.htm serv/ftpicd9/ftpicd9.htm

Summary of Changes for 2006Summary of Changes for 2006

173173 New diagnosis codes New diagnosis codes

1414 New category or subcategory New category or subcategory

titlestitles

2828 Revised diagnosis code titles Revised diagnosis code titles

April 2005 revisions to Guidelines April 2005 revisions to Guidelines

have been incorporated.have been incorporated.

Summary of Changes to the Summary of Changes to the Coding Guidelines Coding Guidelines

Conventions, general coding Conventions, general coding

guidelines and chapter-specific guidelines and chapter-specific

guidelinesguidelines

Addition of V Code TableAddition of V Code Table

• Principal or first listedPrincipal or first listed

• First or additionalFirst or additional

• Additional onlyAdditional only

Changes to ICD-9 for 2006Changes to ICD-9 for 2006 New CodeNew Code

• 259.5 Androgen insensitivity 259.5 Androgen insensitivity syndromesyndrome

276.5 (Volume depletion) has been 276.5 (Volume depletion) has been expanded to require a 5expanded to require a 5thth digit: digit:• 276.50 Volume depletion, unspecified276.50 Volume depletion, unspecified• 276.51 Dehydration276.51 Dehydration• 276.52 Hypovolemia276.52 Hypovolemia

Changes to ICD-9 for 2006Changes to ICD-9 for 2006 New CodeNew Code

• 278.02 Overweight278.02 Overweight 287.3 has been expanded to 5287.3 has been expanded to 5thth digit digit

• 287.30 Primary thrombocytopenia, unspecified287.30 Primary thrombocytopenia, unspecified• 287.31 Immune thrombocytopenic purpura287.31 Immune thrombocytopenic purpura• 287.32 Evans’ syndrome287.32 Evans’ syndrome• 287.33 Congenital and hereditary 287.33 Congenital and hereditary

thrombocytopenic purpurathrombocytopenic purpura• 287.39 Other primary thrombocytopenia287.39 Other primary thrombocytopenia


New CodesNew Codes• 291.82 Alcohol induced sleep 291.82 Alcohol induced sleep

disordersdisorders• 292.85 Drug induced sleep disorders292.85 Drug induced sleep disorders

New Category, subcategories, and New Category, subcategories, and codes for Organic sleep disordercodes for Organic sleep disorder

New Category: Organic Sleep New Category: Organic Sleep DisordersDisorders

• 327.0 Organic disorders of initiating 327.0 Organic disorders of initiating and maintaining sleep (Organic and maintaining sleep (Organic insomnia)insomnia)• 327.00 Organic insomnia, unspecified327.00 Organic insomnia, unspecified• 327.01 Insomnia due to medical 327.01 Insomnia due to medical

condition classified elsewherecondition classified elsewhere• 327.02 Insomnia due to mental disorder327.02 Insomnia due to mental disorder• 327.09 Other organic insomnia327.09 Other organic insomnia

New Subcategory Under Organic New Subcategory Under Organic Sleep Disorders Sleep Disorders

• 327.1 Organic disorders of excessive 327.1 Organic disorders of excessive somnolencesomnolence

• 327.10 Organic hypersomnia, unspecified327.10 Organic hypersomnia, unspecified• 327.11 Idiopathic hypersomnia with long 327.11 Idiopathic hypersomnia with long

sleep timesleep time• 327.12 Idiopathic hypersomnia without long 327.12 Idiopathic hypersomnia without long

sleep timesleep time• 327.14 Hypersomnia due to medical 327.14 Hypersomnia due to medical

condition classified elsewherecondition classified elsewhere• 327.15 Hypersomnia due to mental disorder327.15 Hypersomnia due to mental disorder• 327.19 Other organic hypersomnia327.19 Other organic hypersomnia

New Subcategory Under Organic New Subcategory Under Organic Sleep DisordersSleep Disorders

• 327.2 Organic sleep apnea327.2 Organic sleep apnea• 327.20 Organic sleep apnea, 327.20 Organic sleep apnea,

unspecifiedunspecified• 327.21 Primary central sleep apnea327.21 Primary central sleep apnea• 327.22 High altitude periodic breathing327.22 High altitude periodic breathing• 327.23 Obstructive sleep apnea (adult) 327.23 Obstructive sleep apnea (adult)

(pediatric)(pediatric)• 327.24 Idiopathic sleep related 327.24 Idiopathic sleep related

nonobstructive alveolar hypoventilation nonobstructive alveolar hypoventilation


• 327.2 Organic sleep apnea, con’t.327.2 Organic sleep apnea, con’t.• 327.25 Congenital central alveolar 327.25 Congenital central alveolar

hypoventilation syndromehypoventilation syndrome• 327.26 Sleep related hypoventilation/ 327.26 Sleep related hypoventilation/

hypoxemia in conditions classified hypoxemia in conditions classified elsewhereelsewhere

• 327.27 Central sleep apnea in 327.27 Central sleep apnea in conditions classified elsewhereconditions classified elsewhere

• 327.29 Other organic sleep apnea327.29 Other organic sleep apnea


• 327.3 Circadian rhythm sleep disorder 327.3 Circadian rhythm sleep disorder • 327.30 Circadian rhythm sleep disorder, 327.30 Circadian rhythm sleep disorder,

unspecifiedunspecified• 327.31 Circadian rhythm sleep disorder, 327.31 Circadian rhythm sleep disorder,

delayed sleep phase type delayed sleep phase type • 327.32 Circadian rhythm sleep disorder, 327.32 Circadian rhythm sleep disorder,

advanced sleep phase type advanced sleep phase type • 327.33 Circadian rhythm sleep disorder, 327.33 Circadian rhythm sleep disorder,

irregular sleep-wake typeirregular sleep-wake type


• 327.3 Circadian rhythm sleep disorder,con’t327.3 Circadian rhythm sleep disorder,con’t• 327.34 Circadian rhythm sleep disorder, 327.34 Circadian rhythm sleep disorder,

free-running typefree-running type• 327.35 Circadian rhythm sleep disorder, jet 327.35 Circadian rhythm sleep disorder, jet

lag typelag type• 327.36 Circadian rhythm sleep disorder, shift 327.36 Circadian rhythm sleep disorder, shift

work typework type• 327.37 Circadian rhythm sleep disorder in 327.37 Circadian rhythm sleep disorder in

conditions classified elsewhereconditions classified elsewhere• 327.39 Other circadian rhythm sleep 327.39 Other circadian rhythm sleep

disorder disorder


• 327.4327.4 Organic parasomniaOrganic parasomnia• 327.40 Organic parasomnia, unspecified 327.40 Organic parasomnia, unspecified • 327.41 Confusional arousals327.41 Confusional arousals• 327.42 REM sleep behavior disorder327.42 REM sleep behavior disorder• 327.43 Recurrent isolated sleep paralysis327.43 Recurrent isolated sleep paralysis• 327.44 Parasomnia in conditions 327.44 Parasomnia in conditions

classified elsewhereclassified elsewhere• 327.49 Other organic parasomnia 327.49 Other organic parasomnia


• 327.5 Organic sleep related 327.5 Organic sleep related movement disordersmovement disorders

• 327.51 Periodic limb movement 327.51 Periodic limb movement disorderdisorder

• 327.52 Sleep related leg cramps327.52 Sleep related leg cramps• 327.53 Sleep related bruxism327.53 Sleep related bruxism• 327.59 Other organic sleep related 327.59 Other organic sleep related

movement disordersmovement disorders• 327.8 Other organic sleep disorders 327.8 Other organic sleep disorders

New Codes in Diabetic Retinopathy New Codes in Diabetic Retinopathy SubcategorySubcategory

• 362.03 Nonproliferative diabetic retinopathy 362.03 Nonproliferative diabetic retinopathy NOSNOS

• 362.04 Mild nonproliferative diabetic 362.04 Mild nonproliferative diabetic retinopathyretinopathy

• 362.05 Moderate nonproliferative diabetic 362.05 Moderate nonproliferative diabetic retinopathyretinopathy

• 362.06 Severe nonproliferative diabetic 362.06 Severe nonproliferative diabetic retinopathyretinopathy

• 362.07 Diabetic macular edema362.07 Diabetic macular edemaInstructional note addedInstructional note added


▲ Change in nomenclature Change in nomenclature throughout the 403 and 404 throughout the 403 and 404 sections.sections.▲““renal” disease changed to renal” disease changed to

“kidney” disease”“kidney” disease”▲““renal failure” changed to renal failure” changed to

“chronic “chronic kidney disease”kidney disease”

Changes to ICD-9 for 2006Changes to ICD-9 for 2006• New Codes:New Codes:

• 426.82 Long QT 426.82 Long QT syndromesyndrome

• 443.82 443.82 ErythromelalgiaErythromelalgia


• New Subcategory: 525.4 Complete New Subcategory: 525.4 Complete edentulismedentulism• 525.40 Complete edentulism, unspecified525.40 Complete edentulism, unspecified• 525.41 Complete edentulism, class I525.41 Complete edentulism, class I• 525.42 Complete edentulism, class II525.42 Complete edentulism, class II• 525.43 Complete edentulism, class III525.43 Complete edentulism, class III• 525.44 Complete edentulism, class IV525.44 Complete edentulism, class IV


• New Subcategory: 525.5 Partial New Subcategory: 525.5 Partial edentulismedentulism• 525.50 Partial edentulism, unspecified525.50 Partial edentulism, unspecified• 525.51 Partial edentulism, class I525.51 Partial edentulism, class I• 525.52 Partial edentulism, class II525.52 Partial edentulism, class II• 525.53 Partial edentulism, class III525.53 Partial edentulism, class III• 525.54 Partial edentulism, class IV525.54 Partial edentulism, class IV


▲ 567.2 Other suppurative peritonitis, 567.2 Other suppurative peritonitis, has been expanded to require a fifth has been expanded to require a fifth digit:digit:• 567.21 Peritonitis (acute) generalized567.21 Peritonitis (acute) generalized• 567.22 Peritoneal abscess567.22 Peritoneal abscess• 567.23 Spontaneous bacterial 567.23 Spontaneous bacterial

peritonitisperitonitis• 567.29 Other suppurative peritonitis567.29 Other suppurative peritonitis


▲ 567.3 Retroperitoneal infections, has 567.3 Retroperitoneal infections, has been expanded to require a fifth been expanded to require a fifth digit:digit:• 567.31 Psoas muscle abscess567.31 Psoas muscle abscess• 567.38 Other retroperitoneal abscess567.38 Other retroperitoneal abscess• 567.39 Other retroperitoneal infections567.39 Other retroperitoneal infections


▲ 567.8 Other specified retroperitonitis, 567.8 Other specified retroperitonitis, has been expanded to require a fifth has been expanded to require a fifth digit:digit:• 567.81 Choleperitonitis567.81 Choleperitonitis• 567.82 Sclerosing mesenteritis567.82 Sclerosing mesenteritis• 567.89 Other specified peritonitis567.89 Other specified peritonitis


▲ 585 Revised from “Chronic renal 585 Revised from “Chronic renal failure” to “Chronic kidney disease” failure” to “Chronic kidney disease” and has been expanded to require a and has been expanded to require a forth digit:forth digit:• 585.1 Chronic kidney disease, Stage I585.1 Chronic kidney disease, Stage I• 585.2 Chronic kidney disease, Stage II 585.2 Chronic kidney disease, Stage II

(mild)(mild)• 585.3 Chronic kidney disease, Stage III 585.3 Chronic kidney disease, Stage III

(moderate)(moderate)

Changes to ICD-9 for 2006Changes to ICD-9 for 2006▲ 585 Revised from “Chronic renal 585 Revised from “Chronic renal

failure” to “Chronic kidney disease” failure” to “Chronic kidney disease” and has been expanded to require a and has been expanded to require a fourth digit:fourth digit:• 585.4 Chronic kidney disease, Stage IV 585.4 Chronic kidney disease, Stage IV

(severe)(severe)• 585.5 Chronic kidney disease, Stage V585.5 Chronic kidney disease, Stage V• 585.6 End stage renal disease585.6 End stage renal disease• 585.9 Chronic kidney disease, 585.9 Chronic kidney disease,

unspecifiedunspecified


▲ 599.6599.6 “Urinary obstruction” has “Urinary obstruction” has been expanded to require a fifth been expanded to require a fifth digit:digit:• 599.60 Urinary obstruction, 599.60 Urinary obstruction,

unspecifiedunspecified• 599.69 Urinary obstruction, not 599.69 Urinary obstruction, not

otherwise specifiedotherwise specified

Changes to ICD-9 for 2006Changes to ICD-9 for 2006▲ 651.7 “Multiple gestation following 651.7 “Multiple gestation following

(elective) fetal reduction” has been (elective) fetal reduction” has been expanded to require a fifth digit:expanded to require a fifth digit:• 651.70 Multiple gestation . . . 651.70 Multiple gestation . . .

unspecified unspecified as to episode of care or not as to episode of care or not applicableapplicable

• 651.71 Multiple gestation . . . 651.71 Multiple gestation . . . delivered, delivered, with or without mention of with or without mention of antepartum antepartum conditioncondition

• 651.73 Multiple gestation . . . 651.73 Multiple gestation . . . antepartum condition or complicationantepartum condition or complication


New Codes:New Codes:• 760.77 Noxious influences affecting fetus 760.77 Noxious influences affecting fetus

or newborn via placenta or breast milk, or newborn via placenta or breast milk, AnticonvulsantsAnticonvulsants

• 760.78 Noxious influences affecting fetus 760.78 Noxious influences affecting fetus or newborn via placenta or breast milk, or newborn via placenta or breast milk, Antimetabolic agentsAntimetabolic agents

• 763.84 Meconium passage during delivery763.84 Meconium passage during delivery

Changes to ICD-9 for 2006Changes to ICD-9 for 2006▲ 770.1 Revised from “Meconium 770.1 Revised from “Meconium

aspiration syndrome” to “Fetal and aspiration syndrome” to “Fetal and newborn aspiration” and has been newborn aspiration” and has been expanded to require a fifth digit:expanded to require a fifth digit:• 770.10 Fetal and newborn aspiration, unspecified770.10 Fetal and newborn aspiration, unspecified• 770.11 Meconium aspiration without respiratory 770.11 Meconium aspiration without respiratory

symptomssymptoms• 770.12 Meconium aspiration with respiratory 770.12 Meconium aspiration with respiratory

symptomssymptoms• 770.13 Aspiration of clear amniotic fluid without 770.13 Aspiration of clear amniotic fluid without

respiratory symptomsrespiratory symptoms


• 770.14 Aspiration of clear amniotic 770.14 Aspiration of clear amniotic fluid with respiratory symptomsfluid with respiratory symptoms

• 770.15 Aspiration of blood without 770.15 Aspiration of blood without respiratory symptomsrespiratory symptoms

• 770.16 Aspiration of blood with 770.16 Aspiration of blood with respiratory symptomsrespiratory symptoms

• 770.17 Other fetal and newborn 770.17 Other fetal and newborn aspiration without respiratory aspiration without respiratory symptomssymptoms


• 770.18 Other fetal and newborn 770.18 Other fetal and newborn aspiration with respiratory aspiration with respiratory symptomssymptoms

• 770.85 Aspiration of postnatal 770.85 Aspiration of postnatal stomach contents without stomach contents without respiratory symptomsrespiratory symptoms

• 770.86 Aspiration of postnatal 770.86 Aspiration of postnatal stomach contents with respiratory stomach contents with respiratory symptomssymptoms

• 779.84 Meconium staining779.84 Meconium staining

Changes to ICD-9 for 2006Changes to ICD-9 for 2006▲ In addition to codes in the 327.XX classification, In addition to codes in the 327.XX classification,

codes in the 780.5 subclassification for signs codes in the 780.5 subclassification for signs and symptoms of insomnia have been changed and symptoms of insomnia have been changed in their description.in their description.

! Correction: Code 780.50 was mistakenly Correction: Code 780.50 was mistakenly omitted from ICD-9 for 2006. It is a valid code omitted from ICD-9 for 2006. It is a valid code and reports:and reports:

““Sleep disturbance, unspecified”Sleep disturbance, unspecified”• 780.95 Other excessive crying780.95 Other excessive crying


▲ 799.0 Subcategory descriptor 799.0 Subcategory descriptor revised to “Asphyxia and revised to “Asphyxia and hypoxemia” and has been expanded hypoxemia” and has been expanded to require a fifth digit:to require a fifth digit:• 799.01 Asphyxia799.01 Asphyxia• 799.02 Hypoxemia799.02 Hypoxemia


▲ 996.4 “Mechanical complication of 996.4 “Mechanical complication of internal orthopedic device, implant, internal orthopedic device, implant, and graft” has been expanded to and graft” has been expanded to require a fifth digit:require a fifth digit:• 996.40996.40 Unspecified complication . . . Unspecified complication . . . • 996.41 Mechanical loosening of prosthetic 996.41 Mechanical loosening of prosthetic

jointjoint• 996.42 Dislocation of prosthetic joint996.42 Dislocation of prosthetic joint• 996.43 Prosthetic joint implant failure996.43 Prosthetic joint implant failure


• 996.44 Peri-prosthetic fracture around 996.44 Peri-prosthetic fracture around prosthetic jointprosthetic joint

• 996.45 Peri-prosthetic osteolysis996.45 Peri-prosthetic osteolysis• 996.46 Articular bearing surface wear of 996.46 Articular bearing surface wear of

prosthetic jointprosthetic joint• 996.47 Other mechanical complication of 996.47 Other mechanical complication of

prosthetic joint implantprosthetic joint implant• 996.49 Other mechanical complication of other 996.49 Other mechanical complication of other

internal orthopedic device, implant, and graftinternal orthopedic device, implant, and graft

Changes to ICD-9 for 2006Changes to ICD-9 for 2006V Code ChangesV Code Changes

• V12.42 Personal history of Infections V12.42 Personal history of Infections of the central nervous system of the central nervous system

• V12.60 Personal history of Unspecified V12.60 Personal history of Unspecified disease of respiratory systemdisease of respiratory system

• V12.61 Personal history of Pneumonia V12.61 Personal history of Pneumonia (recurrent)(recurrent)

• V12.69 Personal history of Other V12.69 Personal history of Other diseases of respiratory systemdiseases of respiratory system


• V13.02 Personal history of Urinary (tract) V13.02 Personal history of Urinary (tract) infectioninfection

• V13.03 Personal history of nephrotic V13.03 Personal history of nephrotic syndromesyndrome

• V15.88 Personal history of, History of fallV15.88 Personal history of, History of fall• V17.81 Family history of, OsteoporosisV17.81 Family history of, Osteoporosis• V17.89 Family history of, Other V17.89 Family history of, Other

musculoskeletal diseasesmusculoskeletal diseases• V18.9 Family history of, Genetic disease V18.9 Family history of, Genetic disease

carriercarrier


• V26.31 Testing for genetic disease V26.31 Testing for genetic disease carrier statuscarrier status

• V26.32 Other genetic testingV26.32 Other genetic testing• V26.33 Genetic counselingV26.33 Genetic counseling• V46.13 Encounter for weaning from V46.13 Encounter for weaning from

respirator [ventilator]respirator [ventilator]• V46.14 Mechanical complication of V46.14 Mechanical complication of

respirator [ventilator]respirator [ventilator]


• V49.84 Bed confinement statusV49.84 Bed confinement status▲ V58.1 subcategory descriptor V58.1 subcategory descriptor

revised and expanded to require revised and expanded to require a fifth digit:a fifth digit:• V58.11 Encounter for antineoplastic V58.11 Encounter for antineoplastic

chemotherapychemotherapy• V58.12 Encounter for antineoplastic V58.12 Encounter for antineoplastic

immunotherapyimmunotherapy


• New subcategory requiring fifth digit, V59.7 New subcategory requiring fifth digit, V59.7 Donors, Egg (oocyte) (ovum) Donors, Egg (oocyte) (ovum)• V59.70 Egg . . . Donor, unspecifiedV59.70 Egg . . . Donor, unspecified• V59.71 Egg . . . Donor, under age 35, V59.71 Egg . . . Donor, under age 35,

anonymous recipientanonymous recipient• V59.72 Egg . . . Donor, under age 35, V59.72 Egg . . . Donor, under age 35,

designated recipientdesignated recipient• V59.73 Egg . . . Donor, age 35 and over, V59.73 Egg . . . Donor, age 35 and over,

anonymous recipientanonymous recipient• V59.74 Egg . . . Donor, age 35 and over, V59.74 Egg . . . Donor, age 35 and over,

designated recipientdesignated recipient


• V62.84 Suicidal ideationV62.84 Suicidal ideation• V64.0 subcategory descriptor revised and V64.0 subcategory descriptor revised and

expanded to require a fifth digit, Vaccination expanded to require a fifth digit, Vaccination not carried out . . .not carried out . . .• V64.00 . . . unspecified reason”V64.00 . . . unspecified reason”• V64.01 . . . because of acute illness”V64.01 . . . because of acute illness”• V64.02 . . . because of chronic illness or V64.02 . . . because of chronic illness or

condition”condition”• V64.03 . . . because of immune V64.03 . . . because of immune

compromised compromised state”state”


▲ V64.0 subcategory descriptor revised and V64.0 subcategory descriptor revised and expanded to require a fifth digit, “Vaccination not expanded to require a fifth digit, “Vaccination not carried out . . .carried out . . .• V64.04 . . . because of allergy to vaccine or V64.04 . . . because of allergy to vaccine or

component”component”• V64.05 . . . because of caregiver refusal”V64.05 . . . because of caregiver refusal”• V64.06 . . . because of patient refusal”V64.06 . . . because of patient refusal”• V64.07 . . . for religious reasons”V64.07 . . . for religious reasons”• V64.08 . . . because patient had disease being V64.08 . . . because patient had disease being

vaccinated against”vaccinated against”• V64.09 . . . for other reason” V64.09 . . . for other reason”


• V69.5 Behavioral V69.5 Behavioral insomnia of childhood insomnia of childhood

• V72.4 Pregnancy V72.4 Pregnancy examination or test, examination or test, positive resultpositive result

• V72.86 Encounter for V72.86 Encounter for blood typingblood typing


• New V Code category to report New V Code category to report Body Mass IndexBody Mass Index• V85.0 Body Mass IndexV85.0 Body Mass Index• V85.0 through V85.4 vary from four V85.0 through V85.4 vary from four

digit to five digit codes and report BMI digit to five digit codes and report BMI from 19 to 40 and over, adultfrom 19 to 40 and over, adult

Thank you!Thank you!

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ICD-9 Changes for 2006 Julie A. Leu, CPC Billing Compliance Coordinator September 27, 2005.

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