- The code for nonspecific abnormal Papanicolaou smear of cervix (795.0) has been expanded to 4 new codes to more closely match the Bethesda Pap interpretation language.
- The code for ectopic pregnancy (633) has been expanded to describe an ectopic pregnancy with the presence or absence of an intrauterine pregnancy.
- ICD-9 has added a new sequencing instruction: “Code, if applicable, any causal condition first.” Codes with this note may be used as a principal diagnosis if no causal condition is applicable or known.
- A new code for toxic shock syndrome (040.82) was added in recognition of its often-severe symptoms.
Code revisions for gynecology
256.2, postablative ovarian failure. Artificial menopause (627.4) has been deleted from the “excludes” note that goes with code 256.2. If the patient is experiencing symptoms related to artificial menopause, report 627.4 along with this code.
256.3, other ovarian failure. The instructions to use an additional code for states associated with artificial menopause has been changed to read “states associated with natural menopause (627.2).”
622.1, dysplasia of cervix (uteri). Some terms have been added to the inclusion list that follows the code number. Among the conditions that now qualify for this code are cervical intraepithelial neoplasia I and II, high-grade squamous intraepithelial dysplasia (HGSIL), and low-grade squamous intraepithelial dysplasia (LGSIL).
627.2, natural menopause, and 627.4, artificial menopause. ICD-9 has now added the term “symptomatic” to these codes to differentiate them from asymptomatic menopause.
V49.81, postmenopausal status (age-related) (natural). This code’s descriptor was revised to include the term “asymptomatic” as a counterpart to the changes to 627.2 and 627.4, described above.
V58.83, encounter for therapeutic drug monitoring. A new note added to this code instructs coders to also report a second code indicating any associated long-term current drug use (V58.61–V58.69).
New codes for gynecology
795.0, nonspecific abnormal Papanicolaou smear of cervix. This has been expanded to 4 new codes with the addition of a fifth digit, to more closely match the Bethesda Pap interpretation language. (Note that a repeat Pap due to insufficient cell collection is now coded as 795.09 according to ICD-9-CM Coordination and Maintenance Committee staff. Previously, V76.2 was recommended for insufficient cells):
- 795.00 Nonspecific abnormal Papanicolaou smear of cervix, unspecified
- 795.01 Atypical squamous cell changes of undetermined significance favor benign (ASCUS favor benign); atypical glandular cell changes of undetermined significance favor benign (AGUS favor benign)
- 795.02 Atypical squamous cell changes of undetermined significance favor dysplasia (ASCUS favor dysplasia); atypical glandular cell changes of undetermined significance favor dysplasia (AGUS favor dysplasia)
- 795.09 Other nonspecific abnormal Papanicolaou smear of cervix:
- benign cellular changes
- unsatisfactory smear
- 998.31 Disruption of internal operation wound
- 998.32 Disruption of external operation wound; disruption of operation wound not otherwise specified
- V13.21 Personal history of preterm labor
- V13.29 Other genital system and obstetric disorders