Dermatology is one of the most complex specialties when it comes to diagnosis and coding management. This is why most healthcare providers and dermatologists outsource the services to professional medical billing and coding companies that are dedicated to these tasks. Psoriasis is a notable dermatology disease that is very prevalent in the US.
According to a report, the autoimmune disease affects almost 3% of the adult population, which makes up more than 7.5 million US adults. In order to get quality reporting and statistics as well as reimbursement on claims for all these cases, it is imperative to have complete, compliant coding and proper documentation.
Timely and accurate prevalence estimates are important when it comes to gathering data about diseases. When it comes to psoriasis, it is equally significant to find out the trends and other stats given the sheer number of cases reported each year in the US. While there is existing prevalence information available based on local sample sizes, they are not enough to sedate the demand for an increasing number of administrative data.
Hence the need for using the International Classification of Diseases for documenting the diagnosis and treatment of diseases to allow for swift access to morbidity data. It is imperative for healthcare providers and medical coding and billing specialists to understand and appreciate the benefits of using the ICD 9 code for psoriasis as well as the relevant ICD 10 codes which effectively replaced the ICD 9 in 2015.
The vast data compiled through the ICD helps researchers and medical experts to conduct studies and predict future trends. The medical diagnostic codes for psoriasis should be enough to validate the number of patients and to ascertain the type of psoriasis that is the most prevalent. However, in truth, there is a lack of proper and strict reporting of the procedures and treatment for psoriasis, which can be attributed to a deficiency of knowledge when coding for ICD 9 psoriasis.
What is Psoriasis?
Psoriasis is one of the most prevalent immune-mediated diseases. It is characterized by inflammation in different parts of the body, caused by dysfunction of the human immune system. The inflammation that is caused can be recognized by scales and plaques that appear on the skin.
Psoriasis is caused due to hyperactivity of the immune system that speeds up the growth of the skin cells. Normally, skin cells grow and then shed off in a process that is a month-long. But with psoriasis, this process is done within three or four days, which causes the skin cells to add up and pile on the skin’s surface, including on the scalp, knees, and elbows.
The inflammation that is caused by psoriasis does not only affect the skin, but is found to impact some internal organs and tissues as well, and gradually leading to other health conditions. According to independent research, one in every three patients of psoriasis develops psoriatic arthritis, which is characterized by swollen and stiff joints.
Which Health Care Providers Treat Psoriasis?
Psoriasis is diagnosed and treated by dermatologists who specialize in skin-related diseases and problems. For psoriatic arthritis, you may also seek help from a rheumatologist who specifically provides treatment for joint disorders. However, family physicians and other medical doctors can also provide basic treatment for psoriasis. Other healthcare professionals including holistic practitioners, acupuncturists, chiropractors, and even nutritionists are known to give treatment for psoriasis to some extent or another.
If you are looking for rheumatologists and dermatologists specializing in the treatment of psoriasis, the National Psoriasis Foundation and the American Academy of Dermatology are great sources. They have updated databases with the best specialists near you.
Patients with psoriasis have more chances to contract other comorbidities such as liver problems, diabetes, inflammatory bowel disease, arthritis, and hypertension to name a few. That means that their overall health condition should closely be monitored for other health problems.
A dermatologist or a health care provider can diagnose the condition by
– Obtaining the patient’s medical history
– Getting the patient’s family health history
– Performing a physical examination of the skin
– Microscopic examination of the skin tissues
What is the ICD 9?
The International Classification of Diseases ninth revision is a set of standards containing codes to describe medical diagnoses. The standardized coding means that there is consistency in the recording of patient symptoms and diagnoses among health care providers, which is then used for reimbursement on medical bills and claims.
Each disease or diagnosis is represented by a six-character alphanumeric code that describes in detail that certain condition. Physicians and healthcare providers identify the specific code for treatment they provide which can be entered into the patient’s electronic health record for reporting, diagnostic and billing purposes.
The ICD 9 was introduced in 1975 at the WHO annual conference and the US soon adopted the code set into its medical system. In 2008, CMS announced that the US will be adopting the ICD 10, which many countries had already adopted since its inception in the 90s. However, the health system was hurdled by political and technical issues, due to which it was not until 2015 that the ICD 10 was officially enforced all over the country.
Psoriasis ICD 9
696.1 is the billable code used to indicate a diagnosis for ICD 9 psoriasis, generally covering all the types of the disease. The code can only be used for claims which have a date of service before 30 September 2015. From October 1, 2015, the ICD 9 was effectively replaced by the ICD 10 and was made mandatory to use the corresponding diagnostic codes from the new code set.
Where the psoriasis ICD 9 had a single code to identify all cases of psoriasis, the ICD 10 delves into more details and includes separate codes for each of the types of psoriasis.
Types of Psoriasis
Psoriasis Vulgaris is the general term used to define the condition, which is further divided into various types depending on the appearance and location of the skin inflammation. The ICD 9 psoriasis Vulgaris corresponding code is 696.1 which is equivalent to L40.0 in the ICD 10.
One of the most commonly occurring psoriasis, scalp psoriasis is characterized by inflammation on the forehead, the skin around the ears, and back of the neck, affecting the hairline as well. Psoriasis of scalp ICD 9 code is 696.1 which translates to L40.8 in the ICD 10 code set.
Around 8 percent of the patients having psoriasis have a guttate type. Symptoms include inflamed round, red spots on the torso, legs, and arms.
Pustular psoriasis is rarer than guttate, affecting around 3 percent of the patients living with psoriasis. It is characterized by white, pus-filled pustules surrounded by reddened or inflamed skin.
Around 80 percent of psoriasis patients are affected by this type. Plaques or scales appear anywhere on the body, which can be painful and itchy. The scales vary from silvery white to more purple ones, depending on the skin type of the person. The diagnosis code for plaque psoriasis ICD 9 is the same i.e. 696.1 and converts to L40.0.
Treating Psoriasis with Light Therapy
In recent years, phototherapy or light therapy has emerged as one of the most cost-effective and safest methods to treat psoriasis and other dermatology-related conditions. Especially for mild cases of psoriasis, UVA and UVB light have been known to be effective in reducing the symptoms.
Natural sunlight is also recommended by physicians for the treatment of psoriasis. Regular, controlled exposure to sunlight has been known to do wonders in some patients. However, some areas of the body such as hands and face may need to be protected from direct sun exposure.
In addition, there are various other light sources that act as a substitute for sunlight, like photodynamic therapy and lasers. Some clinics have specially built light sources for UVA and UVB for the treatment.
There is plenty of ongoing research on psoriasis, but there’s still much and more to learn. Given the sheer number of cases reported in the US alone of patients with this condition, it is necessary that the providers accurately document and code the treatment they provide. That will allow researchers to actually decipher what the underlying cause of psoriasis is.
Medicare and private insurer audits are increasing as speak to check on the medical records and documentation concerning psoriasis. It is essential, therefore, to have accurate and detailed documentation to avoid any undue problems. Outsourcing the tedious task to an established medical billing and coding company such as UControl Billing can help ensure that the reporting and coding are carried out error-free for an optimal and timely reimbursement on all claims.
A couple of years ago, I executed the effective plan of creating a Medical billing and Coding company named U Control Billing. The company aims to bring revolutionary advancements to foster medical billing and coding revenues. As an official member of HIA-LI and MGMA, I feel honored in providing networking opportunities, problem-solving, and improving the revenue management cycle.