CCHIS Newsletter for February 2014. Addresses the topics of Coding the Administration of Pharmaceuticals in ICD-9 & ICD-10 PCS and developing a ICD-10 Training Plan.

1. This topic specifically covers the pharmaceuticals in Section 00.1
in the ICD-9 coding book. A pharmaceutical substance can be defined as a
chemical substance put together as a single active ingredient or it can be a
combination of other pharmacological active substances. Pharmaceuticals
are classified in various other groups besides their origin on the basis of
pharmacological properties like manner of action and their
pharmacological activity, such as route of administration, biological
system affected, or therapeutic effects.
The codes found in the ICD-9 PCS section for Pharmaceuticals
include codes 00.10-00.19. The pharmaceuticals are administered mostly
through injections or infusions with the exception of 00.10 Implantation of
Chemotherapeutic Agent and 00.12 Administration of Inhaled Nitric
Oxide. In comparison, ICD-10 PCS codes for this section are found in the
Administration section. The Administration section includes infusions,
injections, and transfusions, as well as other procedures. Both ICD-9 PCS
and ICD-10 PCS list or describe procedures where a diagnostic or
therapeutic substance is given to the patient The Pharmaceutical section
of ICD-9 PCS is considered less traveled because it is less familiar than the
therapeutic and prophylactic substances found in the 99.1-99.4 sections.
Coders should become familiar with the “less traveled”
pharmaceutical codes and their use so that they can make it a practice to
capture them in their day to day coding activity. Coders, however, must be
able to identify the pharmaceuticals and their components in order to code
them accurately in ICD-10 PCS. A good Drug dictionary is an excellent
reference tool whether it is a hard copy or a part of the office software
package.
PHARMACEUTICAL CODING, THE ROAD LESS TRAVELED
WHAT TO EXPECT
1 The Road Less Traveled
2 Coding Scenario
3 ICD-10 Crunch Time
4 Requests for Coding Topics
“The Pharmaceutical
section is considered
less traveled because
it is less familiar….”
FEBRUARY 2014
Volume 1 Issue 2
By Cynthia Brown, MBA, RHIT, CCS
www.cyntcodinghealthinformationservices.com
CCHIS, P.O. Box 3019, Decatur, GA 30031 404-992-8984
http://www.cyntcodinghealthinformationservices.com
Cynthia@cyntcodinghealthinformationservices.com [phone]
CODING YESTERDAY’S NOMENCLATURE TODAY®
Coding the Administration of Pharmaceuticals in
ICD-9 PCS & ICD-10 PCS
CODING NEWSLETTER FOR HEALTHCARE
CODING PROFESSIONALS

2. Page 2 Coding Yesterday’s Nomenclature Today
Let’s take a look at the ICD-9 PCS code 00.12 Administration of
Inhaled Nitric Oxide and how it would translate to ICD-10 PCS. Since the
recognition of nitric oxide (NO) as a key endothelial-derived vasodilator
molecule in 1987, the field of NO research has expanded to encompass
many areas of biomedical research. It is now well established that NO is an
important signaling molecule throughout the body. The therapeutic
potential of inhaled NO as a selective pulmonary vasodilator was suggested
in a lamb model of pulmonary hypertension and in patients with pulmonary
hypertension in 1991. Because NO is scavenged by hemoglobin (Hb) on
diffusing into the blood and is thereby rapidly inactivated, the vasodilatory
effect of inhaled NO is limited largely to the lung. This is in contrast to
intravenously infused vasodilators that can cause systemic vasodilation and
severe systemic arterial hypotension.
A newborn is diagnosed with pulmonary HTN associated with
premature closure of the ductus arteriosus, pneumonia, meconium
aspiration, prematurity, and lung dysplasia. In many infants with pulmonary
hypertension, right-to-left shunting of venous blood across the patent ductus
arteriosus and foramen ovale produces severe systemic hypoxemia. In other
patients, closure of these vascular conduits causes right-side heart failure
and systemic hypotension. Extracorporeal membrane oxygenation (ECMO)
therapy is lifesaving for some infants with pulmonary hypertension;
however, it is costly, invasive, and associated with important morbidities.
Therefore, it is elected to administer inhaled nitric oxide.
In ICD-9, the coder can simply arrive at the correct code by going to
Administration in the ICD-9 codebook and then locate inhaled nitric oxide,
00.12. In ICD-10, the coder should go to Administration in Table of
Contents of the 2014 Tables & Index, then Physiological Systems &
Anatomical Regions (3E), next Administration, Introduction (3E0). The
table should be followed down to the Body System/Region, Respiratory
Tract (F), select the applicable approach (which in this case is via natural
or artificial opening)(7), select Gas (S), and lastly Nitric Oxide (D).
Therefore, in ICD-9 PCS the code is 00.12 while in ICD-10 PCS the code is
3E0F7SD.
www.cyntcodinghealthinformationservices.com
NO signaling pathway in the lung.
“The therapeutic
potential of inhaled NO
as a selective
pulmonary vasodilator
is evident in patients
with pulmonary HTN.”
Coding Scenario

3. Coding Yesterday’s Nomenclature Today
With the implementation date for ICD-10 only seven months away,
it is literally “crunch time” for some organizations. The final stages of
testing, modification, and retesting should be coming to a close. The
education of staff should already be well underway. The transition from
ICD-9 to ICD-10 could prove to be one of the healthcare industries most
widespread changeovers of its kind in decades. The transition will push the
limits of an organization’s human, financial, and technical resources to the
maximum. By now, the costs are making even large organizations shake
their heads. Hopefully, cost estimations were close to predictions.
The education of major contributors to the success of the transition
should have been included in the cost analysis. The plan for educational
training should extend beyond the coders in an organization. With most
organizations believing that educating and training staff is the key
component to the success of the transition a Training Plan is crucial.
Hospitals and other healthcare providers should at this point be making
employee training a priority. A competent educator, whether inside or
outside of the organization, should be consulted to develop a Training Plan.
The Training Plan should be customized to meet the needs of your
particular organization.
The Educator should approach training with the mindset that each
organization is unique and therefore have unique training needs. A formal
assessment of the knowledge of the staff should be conducted before
developing a Training Plan. The results of the assessment will determine the
next steps to take in developing a Training Plan. The Assessment and
Training Plan should include coders, physicians, other clinical staff,
documentation specialists, and any other key staff who will be affected by
accurate code assignment. The sooner a Training Plan is developed the
better. Early development will give an organization time to put into
practice what has been taught and to make adjustments in learning curves.
Remember accurate and complete coding is a must in today’s economically
challenged healthcare environment.
Coding
Yesterday’s
Nomenclature
Today
Coding Health Information Services ®
AHIMA approved ICD-10 CM/PCS
Trainer
ICD-10 CRUNCH TIME
Is Your Training Plan Adequate?
“Accurate and
complete coding is a
must in today’s
economically
challenged healthcare
environment.”

4. Page 4 Coding Yesterday’s Nomenclature Today
CCHIS Professional Affiliates
AHIMA
GHIMA
AHIMA approved ICD-10 CM/PCS
Trainer
EDWOSB/WOSB
VOSB
SCORE Atlanta
CyntCoding Health Information
Services
P.O. BOX 3019
Decatur, GA 30031
Phone:
404-992-8984
E-Fax:
678-805-4919
E-mail:
cyntcoder1@aol.com or cyntcoder1@gmail.com
Requests for Coding Topics
E-mail your coding topics using the format below to:
cyntcoder@cyntcodinghealthinformationservices.com
CCHIS NEWSLETTER
TERMS AND CONDITIONS OF USE
All content provided in this “CCHIS Newsletter” is for informational purposes only. The owner
of this newsletter makes no representations as to the accuracy or completeness of any information
in this newsletter or found by following any link in this newsletter.
The owner of http://cyntcodinghealthinformationservices.com will not be liable for any errors or
omissions in information nor for the availability of this information. The owner will not be liable
for any losses, injuries, or damages from the display or use of this information. The terms and
conditions are subject to change at any time with or without notice.
CODING YESTERDAY’S NOMENCLATURE TODAY®
www.cyntcodinghealthinformationservices.com