In a recent newsletter from CMS, I came across an interesting notice.  A new Remittance Advice Remark Code (RARC) N742 will begin to show up on your Medicare remittances sometime in April.  This code is being implemented ahead of what seems to continue to be the official effective date for ICD-10, October 1, 2015.  You may have even already seen it since it has been effective for other health plans to use since March 1, 2015.

N742 – Alert: This claim was processed based on one or more ICD-9 codes. The
transition to ICD-10 is required by October 1, 2015, for health care providers, health
plans, and clearinghouses. More information can be found at http://www.cms.gov/Medicare/Coding/ICD10/ProviderResources.html.

Coincidentally, I read an article that continues to discuss the transition and the burdens/disruptions it is due to cause providers come this October.  That article made a really good point that family practice/internal medicine type practitioners will most likely be affected more than highly specialized practices.  This makes pretty good sense.  The wider range of conditions treated means more conversions.

 

I am no longer involved in billing in an office setting, but I imagine by now, practice administrators have put into development some type of conversion table for the most common conditions treated in the practice. 

As my own little experiment, I took some of the most commonly used diagnosis codes in radiation oncology and converted them with the ICD-9 to ICD-10 Coding Crosswalk tool found in our cloud based medical billing software, Iridium Suite.

 

If your software is not ICD-10 compliant or you would like to have a medical billing system with a built-in crosswalk tool, contact us at sales@iridiumsuite.com today!!  October will be here before you know it.

 

162.3 Malignant neoplasm of upper lobe bronchus or lung now has three choices:

C34.10 Malignant neoplasm of upper lobe, unspecified bronchus or lung, OR

C34.11 Malignant neoplasm of upper lobe right bronchus or lung, OR

C34.12 Malignant neoplasm of upper lobe left bronchus or lung

162.5 Malignant neoplasm of lower lobe bronchus or lung now has three choices:

C34.30 Malignant neoplasm of lower lobe, unspecified bronchus or lung, OR

C34.31 Malignant neoplasm of lower lobe right bronchus or lung, OR

C34.32 Malignant neoplasm of lower lobe left bronchus or lung

Billing note:  The codes are adding specificity with left or right side.

174.1 Malignant neoplasm of central portion of female breast

C50.111 Malignant neoplasm of central portion of right female breast, OR

C50.112 Malignant neoplasm of central portion of left female breast, OR

C50.119 Malignant neoplasm of central portion of unspecified female breast

174.2 Malignant neoplasm of upper-inner quadrant of female breast

C50.211 Malignant neoplasm of upper-inner quadrant of right female breast, OR

C50.212 Malignant neoplasm of upper-inner quadrant of left female breast, OR

C50.219 Malignant neoplasm of upper-inner quadrant of unspecified female breast

174.3 Malignant neoplasm of lower-inner quadrant of female breast

C50.311 Malignant neoplasm of lower-inner quadrant of right female breast, OR

C50.312 Malignant neoplasm of lower-inner quadrant of left female breast, OR

C50.319 Malignant neoplasm of lower-inner quadrant of unspecified female breast

174.4 Malignant neoplasm of upper-outer quadrant of female breast

C50.411 Malignant neoplasm of upper-outer quadrant of right female breast, OR

C50.412 Malignant neoplasm of upper-outer quadrant of left female breast, OR

C50.419 Malignant neoplasm of upper-outer quadrant of unspecified female breast

174.5 Malignant neoplasm of lower-outer quadrant of female breast

C50.511 Malignant neoplasm of lower-inner quadrant of right female breast, OR

C50.512 Malignant neoplasm of lower-inner quadrant of left female breast, OR

C50.519 Malignant neoplasm of lower-inner quadrant of unspecified female breast

174.8 Malignant neoplasm of other specified sites of female breast

C50.811 Malignant neoplasm of overlapping sites of right female breast, OR

C50.812 Malignant neoplasm of overlapping sites of left female breast, OR

C50.819 Malignant neoplasm of overlapping sites of unspecified female breast

Billing note: While looking the codes up for female breast cancer, I noticed that the two male breast cancer codes: 175.0 and 175.9 are now represented by same variety and specificity as the female breast.  They replace the fifth digit “1” with “2” to indicate the patient is male. 

185 Malignant neoplasm of prostate

C61 Malignant neoplasm of prostate

Billing note: Interesting, this code has an exact one to one conversion.

198.3 Secondary malignant neoplasm of brain and spinal cord

C79.31 Secondary malignant neoplasm of brain, OR

C79.32 Secondary malignant neoplasm of cerebral meninges, OR

C79.40 Secondary malignant unspecified part of nervous system, OR

C79.49 Secondary malignant neoplasm of other parts of nervous system

198.5 Secondary malignant neoplasm of bone and bone marrow

C79.51 Secondary malignant neoplasm of bone, OR

 C79.52 Secondary malignant neoplasm of bone marrow

There have been many articles on the “odd” diagnosis codes that are contained in the ICD-10 version. It is highly unlikely anyone I know will need to code injured while on flaming skis or struck by a turtle. I am pleased to see the implication on radiation oncology neoplasm coding seems logical and organized.