Home Health Agencies Avoid Rejected Claims: New ICD-9-CM updates

Update to Dementia Codes in ICD-9.

On October 1, 2011, the new 2012 ICD-9-CM codes go into effect.  There are 166 new codes this year, 168 revisions and 88 deleted codes.  This will be the last year for ICD-9-CM code updates as next year there will be a freeze to help prepare for ICD-10.  One of the more important changes that affects home health agencies is the addition of new Dementia codes.  Dementia NOS (294.8) will be deleted on October 1, so any claims submitted with this code will be rejected.

The codes that take the place of 294.8 are:

294.20 Dementia, unspecified, without behavioral disturbance

  • Dementia NOS

294.21 Dementia, unspecified, with behavioral disturbance

  • Aggressive behavior
  • Combative behavior
  • Violent behavior
  • Use additional code, where applicable, to identify: Wandering in conditions classified elsewhere (V40.31)

What date you should begin using the new ICD-9-CM codes is determined by your M0090 date.  For M0090 dates beginning on or after October 1, 2011, use the 2012 codes for the RAP and EOE.  Make sure you check your recertification assessments as well and make any changes to the ICD-9-CM codes to prevent any claims being rejected.

Having Trouble With Rejected Claims?  We Can Help. 
Coding is one of the greatest drains on home health agencies. It takes up valuable time and requires highly skilled employees that are often hard to find and even harder to keep.

HEALTHCAREfirst’s certified home health coding experts help relieve the administrative and technical burdens of in-house coding at a highly competitive price. Their sole focus is on home health coding and they receive continual education on regulations, rules and best practices. As a result of this experience and education, you will have fewer denied and rejected claims, allowing you to get paid more quickly and accurately.

For more information about HEALTHCAREfirst‘s Coding Services click here or call us at 800.841.6095