How to code "dyslipidemia" |
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A common coding error is often made by coders when coding the condition of “dyslipidemia.” (Many coders presume, rightfully from a linguistic standpoint, that "dyslipidemia" could, strictly speaking, be lipidemia that is either too high or too low and that the "dys-" prefix doesn't really indicate to the coder exactly what the lipid problem might be.)
Most coders probably know that the prefix “dys-” means “bad,” or “inappropriate,” so “dyslipidemia” would simply mean an inappropriate level of lipids on the patient’s blood. Unfortunately, the term doesn’t tell the coder if the lipid level is too high or too low—only that it’s out of whack (“dys-”). So it would make sense to code this condition with code 272.9 “Unspecified disorder of lipid metabolism.” However, this in one of those instances where there is a somewhat counterintuitive coding rule in place. There is actually an entry in the ICD-9-CM alphabetical index that directs coders to use code 272.4 “Other and unspecified hyperlipidemia.” Some commentary found in Coding Clinic for ICD-9-CM further clarified this rule, lest there be any misunderstanding. This official commentary can be found in the the first quarter 2005 issue: "Question: What is the correct ICD-9-CM code for dyslipidemia" "Answer: Assign code 272.4, Other and unspecified hyperlipidemia for dyslipidemia." Evidently no one ever means “lipids are too low” when they say “dyslipidemia.” So the ICD-9-CM Coordination and Maintenance Committee seems to be playing the odds and they are presuming that “dyslipidemia” is being used primarily in cases where the lipids are too high. So, although it may be somewhat counterintuitive, remember that “dyslipidemia” is properly coded as 272.4, not 272.9. Greg Schnitzer, CodeRyte, Inc. |