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JCIH Recommendations for Following Children At Risk for Hearing Loss With newborn hearing screening, the Joint Commission on Infant Hearing (JCIH) has recommendations for following children who may be at risk for late onset or progressive hearing loss. Below are some of the codes that might be used when following this population. 1. Caregiver concerns regarding hearing, speech, language, or developmental delay Developmental delay Speech-language concerns ICD-9 Code 315.8 315.31 ICD-9 Description ICD-10 Code ICD-10 Description Other specified delays in development Expressive language disorder F88 Other disorders of psychological development Expressive language disorder F80.1 2. Family history of permanent childhood hearing loss History of hearing loss ICD-9 Code V19.2 ICD-9 Description ICD-10 Code ICD-10 Description Family history of deafness or hearing loss Z82.2 Family history of deafness and hearing loss 3. Neonatal intensive care of more than 5 days or any of the following, regardless of length of stay: extracorporeal membrane oxygenation (ECMO), assisted ventilation, exposure to ototoxic medications (gentamycin and tobramycin) or loop diuretics (furosemide/Lasix), and hyperbilirubinemia that requires exchange transfusion ECMO ICD-9 Code V15.87 ICD-9 Description Hyperbilirubinemia 277.4 Loop diuretics 995.29 Unspecified adverse effect of other drug, medicinal and biological substance Low birth weight 765.00 Extreme immaturity, unspecified [weight] History of extracorporeal membrane oxygenation (ECMO) Disorders of bilirubin excretion ICD-10 Code Z92.81 E80.6 T50.1X5must have 7th character for episode of care P07.00 P07.01 P07.02 P07.03 765.10 Ototoxic medications 995.29 Other preterm infants, unspecified [weight] Unspecified adverse effect of other drug, medicinal and biological P07.10 P07.14 P07.15 P07.16 P07.17 P07.18 T36.5X5must ICD-10 Description Personal history of extracorporeal membrane oxygenation (ECMO) Other disorders of bilirubin metabolism Adverse effect of loop (high ceiling) diuretics… …initial encounter …subsequent encounter …sequela Extremely low birth weight newborn, unspecified weight …… less than 500 grams …… 500-749 grams …… 750-999 grams Other low birth weight newborn, unspecified weight …… 1000-1249 grams …… 1250-1499 grams …… 1500-1749 grams …… 1750-1999 grams …… 2000-2499 grams Adverse effect of aminoglycosides… …initial encounter substance AND [Duplication in chart below] E930.8 Premature 765.20 Other specified antibiotics causing adverse effects in therapeutic use Unspecified weeks of gestation have 7th character for episode of care …subsequent encounter …sequela P07.20 Extreme immaturity of newborn, unspecified weeks of gestation Extreme immaturity of newborn, gestational age less than 23 completed weeks Extreme immaturity of newborn, gestational age 23 completed weeks 765.21 Less than 24 completed weeks of gestation P07.21 765.21 Less than 24 completed weeks of gestation P07.22 765.22 24 completed weeks of gestation P07.23 Extreme immaturity of newborn, gestational age 24 completed weeks 765.23 25-26 completed weeks of gestation P07.24 Extreme immaturity of newborn, gestational age 25 completed weeks 765.23 26-27 completed weeks of gestation??? P07.25 Extreme immaturity of newborn, gestational age 26 completed weeks 765.24 27-28 completed weeks of gestation P07.26 Extreme immaturity of newborn, gestational age 27 completed weeks 765.20 Unspecified weeks of gestation P07.30 765.24 27-28 completed weeks of gestation P07.31 765.25 29-30 completed weeks of gestation P07.32 765.25 30-31 completed weeks of gestation P07.33 765.26 31-32 completed weeks of gestation P07.34 765.26 31-32 completed weeks of gestation P07.35 765.27 33-34 completed weeks of gestation P07.36 765.27 33-34 completed weeks of gestation P07.37 765.28 35-36 completed weeks of gestation P07.38 765.28 35-36 completed weeks of gestation P07.39 Preterm newborn, unspecified weeks of gestation Preterm newborn, gestational age 28 completed weeks Preterm newborn, gestational age 29 completed weeks Preterm newborn, gestational age 30 completed weeks Preterm newborn, gestational age 31 completed weeks Preterm newborn, gestational age 32 completed weeks Preterm newborn, gestational age 33 completed weeks Preterm newborn, gestational age 34 completed weeks Preterm newborn, gestational age 35 completed weeks Preterm newborn, gestational age 36 completed weeks 4. In utero infections, such as CMV, herpes, rubella, syphilis, and toxoplasmosis CMV ICD-9 Code 771.1 Herpes 771.2 Rubella Syphilis 771.0 090.9 Toxoplasmosis 130.9 ICD-9 Description ICD-10 Code ICD-10 Description Congenital cytomegalovirus infection Other congenital infections specific to the perinatal period Congenital rubella Congenital syphilis, unspecified P35.1 Congenital cytomegalovirus infection Congenital herpes viral [herpes simplex] infection Toxoplasmosis, unspecified B58.9 P35.2 P35.0 A50.9 OR A50.2 Congenital rubella syndrome Congenital syphilis, unspecified Early congenital syphilis, unspecified Toxoplasmosis, unspecified 5. Craniofacial anomalies, including those that involve the pinna, ear canal, ear tags, ear pits, and temporal bone anomalies Cauliflower ear Microtia No pinna (ear) Narrowing of external ear canal Temporal bone anomalies ICD-9 Code 738.7 ICD-9 Description ICD-10 Code ICD-10 Description Cauliflower ear M95.10 Cauliflower ear, unspecified ear 744.23 744.01 Microtia Absence of external ear M95.11 M95.12 Q17.2 Q16.0 744.02 Other anomalies of external ear with impairment of hearing Q16.1 756.0 Anomalies of skull and face bones Q75.0 right ear left ear Microtia Congenital absence of (ear) auricle Congenital absence, atresia and stricture of auditory canal (external) Craniosynostosis 6. Physical findings, such as white forelock, that are associated with a syndrome known to include a sensorineural or permanent conductive hearing loss ICD9 Code ICD-9 Description ICD-10 Code ICD-10 Description Crouzon's disease 756.0 Q75.1 Craniofacial dysostosis Hypertelorism 756.0 Q75.2 Hypertelorism Macrocephaly 756.0 Q75.3 Macrocephaly Oculomandibular dysostosis Other anomalies not listed above 756.0 Anomalies of skull and face bones Anomalies of skull and face bones Anomalies of skull and face bones Anomalies of skull and face bones Anomalies of skull and face bones Q75.5 Oculomandibular dysostosis Q75.8 Treacher Collins syndrome 756.0 Anomalies of skull and face bones Q75.4 Other specified congenital malformations of skull and face bones Mandibulofacial dysostosis 756.0 Unspecified physical findings not listed above White forelock White forelock (Piebaldism) 756.0 Anomalies of skull and face bones Q75.9 704.3 270.2 Variations in hair color Other disturbances of aromatic amino-acid metabolism L67.1 E70.39 Congenital malformation of skull and face bones, unspecified Variations in hair color Oculocutaneous albanism, unspecifed 7. Syndromes associated with hearing loss or progressive or late-onset hearing loss, such as neurofibromatosis, osteopetrosis, and Usher syndrome; other frequently identified syndromes, including Waardenburg, Alport, Pendred, and Jervell and Lange-Nielson Alport syndrome ICD-9 Code 759.89 ICD-9 Description ICD-10 Code ICD-10 Description Other specified congenital anomalies Long QT syndrome Q87.81 Alport syndrome I45.81 Long QT syndrome Q85.00 Q78.0 Neurofibromatosis, unspecified Osteogenesis imperfecta Jervell and LangeNielson Neurofibromatosis 426.82 Osteogenesis imperfecta Pendred syndrome “Stone bone”; Albers-Schonberg disease Usher syndrome 756.51 Neurofibromatosis, unspecified Osteogenesis imperfecta 246.1 756.52 Dyshormonogenic goiter Osteopetrosis E07.1 Q78.2 Dyshormogenetic goiter Osteopetrosis 362.75 H35.53 Waardenburg syndrome 270.2 Other dystrophies primarily involving the sensory retina Other disturbances of aromatic amino-acid metabolism Other dystrophies primarily involving the sensory retina Other disorders of aromatic amino-acid metabolism 237.70 E70.8 8. Neurodegenerative disorders, such as Hunter syndrome, or sensory motor neuropathies, such as Friedreich ataxia and Charcot-Marie-Tooth syndrome Charcot-MarieTooth syndrome Friedreich ataxia Hunter syndrome ICD-9 Code 356.2 334.0 277.5 ICD-9 Description ICD-10 Code ICD-10 Description Hereditary sensory neuropathy Friedreich's ataxia Mucopolysaccharidosis G60.0 Hereditary motor and sensory neuropathy Early-onset cerebellar ataxia Mucopolysaccharidosis, type II G11.1 E76.1 9. Culture-positive postnatal infections associated with sensorineural hearing loss, including confirmed bacterial and viral (especially herpes viruses and varicella) meningitis Bacterial meningitis ICD-9 Code 320.9 Herpes meningitis Varicella meningitis 053.0 052.7 Viral meningitis 047.9 ICD-9 Description ICD-10 Code ICD-10 Description Meningitis due to unspecified bacterium Herpes zoster with meningitis Chickenpox with other specified complications Unspecified viral meningitis G00.9 B02.1 B01.0 Bacterial meningitis, unspecified Zoster meningitis Varicella meningitis A87.9 Viral meningitis, unspecified 10. Head trauma, especially basal skull/temporal bone fracture that requires hospitalization Chemotherapy ICD-9 Code E933.1 OR 995.29 ICD-9 Description ICD-10 Code ICD-10 Description Antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use T45.1X5 – select 7th digit for episode of care Adverse effect of antineoplastic and immunosuppressive drugs… …initial encounter …subsequent encounter …sequela S02.4 category – will need to select encounter, location, and type of fracture S02.8XXA –7th digit for episode of care Fracture of malar, maxillary and zygoma bones… …initial encounter …subsequent encounter …sequela Fractures of other specified skull and facial bones, initial encounter for closed fracture… …initial encounter …subsequent encounter …sequela Fractures of other specified skull and facial bones, initial encounter for open fracture Unspecified adverse effect of other drug, medicinal and biological substance Fracture of unspecified bone, closed Closed skull fracture 829.0 Closed skull fracture 802.8 Closed fracture of other facial bones Open skull fracture 802.9 Open fracture of other facial bones S02.8XXB About The 7th Character The 7th character represents one of the most significant differences between ICD-9 and ICD-10, because ICD-9 does not provide a mechanism to capture the details that the 7th character provides. You must assign a 7th character to codes in certain ICD-10-CM categories as noted within the Tabular List of codes—primarily Chapter 19 (Injury, poisoning and certain other consequences of external causes) and Chapter 15 (Pregnancy, childbirth and the puerperium). This character must always be in the 7th position. If a code has fewer than 6 characters and requires a 7th character extension, you must fill in all of the empty character spaces with a placeholder “X.” The three characters used are “A,” “D,” and “S,” which represent the following: A – Initial encounter or the first time the audiologist sees a patient (it should be used during active treatment of a condition during hospitalization or surgery) D – Subsequent encounter, follow-up for routine healing or recovery (it is not a repeat of the injury or illness) S – Sequela, late effect of an illness or injury (there are no time limits on sequela; it can be used after the first time you code with an “A” or after years have passed) For follow-up visits, the audiologist would use either the “D” or “S” as the 7th character. For example, for a patient who is seen for a problem and is asked to return for a progress check, you might use a “D.” For a patient who is coming for regular evaluations, you probably should use an “S” for the sequela or late effect of condition. For more information, visit http://www.webpt.com/blog/post/understanding-icd-10-codestructure.
