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ICD Codes

 

14. This Businessline also clarifies, for staff/delegates, the list of diseases and revised ICD codes for which compensation can be claimed under ss7(2) of the SRCA.  The list was originally identified by the Doctor's Advisory Committee in 2005-06 and was based on consideration of the results from the Study of Health Outcomes in Aircraft Maintenance Personnel (SHOAMP), for conditions related to F-111 deseal/reseal work.  Since the list was initially released, some coding issues have arisen that required clarification including clarification already provided following a 2008 review.

 

15. The allocation of  ICD-10 codes assists with matching the diagnosis of the deseal/reseal claimed condition to the ss7(2) pathology list.  ICD-10 codes are allocated to remove ambiguities around claimable conditions and as an adjunct to verify or clarify diagnoses.

 

16. The 2008 review determined that the interpretation of some of the identified conditions should be widened.  For example, diverticulitis has been added to the list against ICD code K57 (Diverticulosis and Diverticular disease).  The review also found that in some instances the interpretation of some conditions should be tightened. For example bowel polyps should be coded under two codes, benign neoplasm – D 12, and any colon polyp – K63.5.  The ICD-10 code is specific but the labelling and description are non-specific.

 

17. The Principal Medical Adviser (PMA) has provided advice on the following ICD-10 codes to clarify certain conditions from the ss7(2) list:

  • impaired cognition and memory loss – F04 and F03;
  • agoraphobia with panic disorder – F40.01;
  • panic disorders – F41.0
  • sleep disorder with neurological basis (associated with Parkinson's Disease or degeneration of the cerebrum) – G47.31; and
  • irritable bowel disease and irritable bowel syndrome are the same condition – K58.

 

18. The list of ICD-10 codes has been amended incorporating this advice, specifically, to add:

a) diverticulosis and diverticular disease to diverticulitis category, all utilising code K57; and

b) ICD-10 code of K63.5 to the existing code of D12 for bowel polyps,

and to clarify that staff should continue to use the following codes:

  • F03 for impaired cognition and F04 for memory loss;
  • F41.0 for panic disorders and F40.01 for agoraphobia with panic disorder; and
  • G47.31 for 'sleep disorder with neurological basis'.

 

19. The revised list of the ICD codes applicable to the 31 conditions that can be accepted under ss7(2) for tier classified personnel is at Attachment B.  This must be used for all decisions involving the application of ss7(2) of the SRCA in respect of tier-classified personnel.  See Attachment D.6 for the procedures to be followed when assessing a compensation claim for a ss7(2) condition.