For those of us in an ASC setting, the system sections where we will see changes are the nervous section with the inclusion of a number of different headache conditions where injections may be given in the cervical area for pain relief. In the Integumentary system there is now a specific code for plantar warts and conditions of the breast along with diagnosis codes for varying degrees of skin ulcers and a condition called “erythema multiforme” which are a types of skin lesions. Today however we are going to discuss a couple of new codes in the urinary section, hematuria and functional urinary incontinence. A patient with blood in their urine would be diagnosed with a condition called hematuria. There are two forms of this condition either gross hematuria where the blood can be seen with the naked eye or microscopic hematuria where the blood is only identifiable under microscopic examination. For this reason diagnosis code 599.7 (hematuria) was expanded to a 5th digit subclassification to differentiate between the two different types of hematuria.
• 599.70 Hematuria, unspecified
• 599.71 Gross hematuria
• 599.72 Microscopic hematuria
The same is true for diagnosis code 788.9 – other symptoms involving urinary system, where a 5th digit is now necessary to identify functional urinary incontinence. With functional incontinence the patient doesn’t have any of the problems that are usually associated with the urinary anatomy such as a weak bladder or obstruction but they do have other physical or mental conditions that are attributed to their incontinence. An example of physical incontinence would be someone with severe arthritis in their hands that could not undress themselves in time to urinate. Mental conditions such as Parkinson’s or Alzheimer’s inhibit an individual’s ability to realize that they need to urinate.
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