The New ICD-10-CM Code Updates Are Here — Are You Ready?

 Today’s the day!  Yes, the annual switching of the diagnosis codes takes place today. Are you aware that there are hundreds of new changes (21 deletions, 30 revisions, and 273 new codes) affecting multiple chapters? Are you prepared? Take time right now and check out what is happening before you start getting claim denials. You need to update your coding tools and internal forms, and begin working on clinical documentation improvement processes to ensure providers are all set to take on these changes.

The following is a breakdown, by chapter, of the ICD-10-CM changes  effective today , October 1, 2019.

Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99)

• A small revision in the description changed[STEC] to (STEC) for B96.21, B96.22, B96.23. Remember, in the instructional guidelines, ( ) parentheses enclose supplementary words not included in the description (or not) and [ ] brackets enclose synonyms, alternative wording, or explanatory phrases.

Chapter 2: Diseases of the Blood and Blood-Forming Organs & Certain Disorders Involving the Immune Mechanism (D50-D89)

• Added a code for Glucose-6-phosphate dehydrogenase (G6PD)
• Expanded the codes for reporting Adenosine deaminase deficiency (see D81.30-D81.39)

Chapter 6: Diseases of the Nervous System

• Revision of cyclical vomiting codes G43.A0 and G43.A1 to include “migraine”

Chapter 7: Diseases of the Eye and Adnexa (H00-H59)

• Central origin vertigo has been expanded to include laterality (H81.4-)

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Chapter 9: Diseases of the Circulatory System (I00-J99)

• Two new codes have been added to report subsegmental pulmonary embolisms (PE) without acute cor pulmonale:
• I26.93 single subsegmental PE without acute cor pulmonale
• I26.94 multiple subsegmental PE without acute cor pulmonale
• Do ICD-10 Updates Have Your Heart Beating Irregularly? Check Out the New Atrial Fibrillation Codes by CLICKING HERE. Sub-categories I48.1- and I48.2- are expanded and will require greater documentation details.
• Revision of codes I70.238 (right leg) and I70.248 (left leg) changed the end of the description as follows: Athersclerosis of native arteries of (right or left) leg with ulceration of other part of lower (right or left) leg.
• Codes in categories I80-I82 have been added to report phlebitis, thrombophlebitisas, and acute or chronic embolism and thrombosis affecting two newly specified vessels:
• peroneal (fibular)
• vein calf muscular vein(s)

CLICK HERE to check out our ICD-10-CM specialty-specific books which have the vital coding information you need for the most commonly reported codes for your specialty.

Chapter 10: Diseases of the Respiratory System (J00-J99)

• A simple parenthetical revision to change “acute” to “(acute)” (J44.0)

Chapter 12: Diseases of the Skin and Subcutaneous Tissue (L00-L99)

• New pressure ulcer codes were added Pressure Ulcer category (L89) to specify “pressure-induced deep tissue injury (DTI) ulcers.” New codes for this type of pressure ulcer are based on anatomic site.

Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)

• Revisions on several code descriptions in this chapter include:
• M50.120: Mid-cervical disc disorder, unspecified to unspecified level
• M66.88: Spontaneous rupture of other tendons, other to other sites
• M67.839 Other specified disorders of synovium and tendon, unspecified forearm to unspecified wrist
• M77.50-M77-52: Other enthesopathy of (unspecified, right, or left) foot to (unspecified, right, or left) foot and ankle

Chapter 14: Diseases of the Genitourinary System (N00-N99)

• Code description revision to include N35.814 "Other anterior urethral stricture, male, anterior" to just male
• Category expansion with new codes to identify laterality for an unspecified lump in the right (N63.15) or left (N63.25) breast, overlapping quadrants
• A new code to report post endometrial ablation syndrome (N99.85)

Chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99)

• Congenital deformities of the feet (category Q66-) has been greatly expanded to include 24 new codes describing laterality (right, left, unspecified)
• Expansion of Q79.6- to provide codes for more specific types of Ehlers-Danlos syndrome
• Prader-Willi syndrome was separated out of the new subcategory Q87.1- as follows:
• Q87.11 Prader-Willi syndrome
• Q87.19 Other congenital malformation syndrome predominantly associated with short stature

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Chapter 18: Symptoms, Signs, and Abnormal Clinical and Laboratory Findings, NEC (R00-R99)

• Added codes for pyuria (R82.81) and Other abnormal findings on cytological and histological examination of urine (R82.89)
• Revised code R82.993 to fix a spelling error. Hyperuricoscuria is really hyperuricosuria

Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)

• A significant number of newly added codes expand orbital fractures by site and laterality (i.e., roof [S02.1-], medial wall [S02.83-], lateral wall [S02.84-], and unspecified side [S02.85X-]
• Code description revisions were done to identify types of psychodysleptics [hallucinogens] (T40.906-) and parasympathomimetrics [cholinergics] (T44.1X6-). Remember, [ ] brackets enclose synonyms, alternative wording, or explanatory phrases, so this will help identify those complicated medications associated with underdosing.
• A large number of "Poisoning by…" codes have been added (T50.911- through T50.916-) mostly due to adding 7th characters.
• New codes for specific types of heatstroke (T67.09X-) have been added (i.e., heatstroke and sunstroke, exertional type, other type)

Chapter 20: External Causes of Morbidity (V00-Y99)

• Revision to the wording for Car passenger injuries (V43.13X-)
• A serious expansion of category Y35 which includes 74 codes describing various injuries caused by legal interventions. The new codes identify the instrument used in the action causing the injury (e.g., types of firearms, explosives, gases, blunt and sharp objects, manhandling, conducted energy devices)

There are more than code changes. The  2020 Official ICD-10-CM Coding Guideline Changes  are also revised! Be sure to review these changes so you are ready for any coding and documentation questions that may arise. CLICK HERE to read about it.

Chapter 21: Factors Influencing Health Status and Contact with Health Services (Z00-Z99)

• New codes to report an encounter for examination of the eyes following a failed vision screening with (Z01.020) and without (Z01.021) abnormal findings
• An expansion of categories Z20-Z29 “Carrier of Infectious Disease” to add testing for latent tuberculosis infection (Z11.7) or latent tuberculosis (Z22.7)
• Care for neurostimulator devices in any anatomic site may now be reported with revised code Z45.42. Previously, the code description limited reporting based on anatomic site (i.e., brain, peripheral nerve, spinal cord), but the revised code removed specific sites, making it eligible to report wherever the device is located.
• A new code to report the presence of a neurostimulator (Z96.82) has been added to the codeset. Don’t forget, when the encounter is not related to assessment or management of the device Z96.82 “Presence of neurostimulator” may be reported; however, when the encounter is all about testing, interrogating, or adjusting the device, it should be reported with Z45.42.
• A simple revision for consistency was made to Body Mass Index 50.0-59.0, adult (Z68.43) to change 50 to 50.0.
• A new code has been added to report an encounter to health counseling related to travel (Z71.84)
• “Personal history of” indicates the patient once had the condition or disease but it no longer exists and they do not receive any on-going or periodic treatment for it. New codes have been added to subcategory Z86.00- “Personal history of in-situ neoplasm” (a pre-malignant growth that hasn’t spread) for certain anatomic sites (i.e., unspecified genital organs, oral cavity, esophagus, stomach, unspecified digestive organs, middle ear, respiratory system, melanoma in-situ, in-situ neoplasm of skin)

Don’t forget, January is just around the corner and that means CPT and HCPCS changes. Our specialty-specific  Reimbursement Guides  provide important coding information, helpful tips, and resources to assist in your daily coding and auditing tasks. Pre-order your copy today.

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