ICD-10 New Codes: Pressure Mounts as Deadline Approaches When New Codes Become Effective

Now it’s just a little less than three weeks until the beginning of October and when the fiscal year (FY) 2018 changes for ICD-10-CM take effect. 

Here is a summary of the new changes for ICD-10-CM:

• 360 new code additions
• 142 deletions
• 250+ revisions

The Centers for Medicare and Medicaid Services (CMS) published a variety of great tables and lists for all to obtain and read. To access the new ICD-10-CM codes, go to the CMS website, to find the links and files: https://www.cms.gov/Medicare/Coding/ICD10/2018-ICD-10-CM-and-GEMs.html

I’d like to provide you with a short summary of a few of the new codes added to each Chapter of ICD-10-CM.

Chapter 1: New A04.71 Enterocolitis due to Clostridium difficile, recurrent
New A04.72 Enterocolitis due to Clostridium difficile, not specified as recurrent

Chapter 2: New C96.20 Malignant mast cell neoplasm, unspecified
New C96.21 Aggressive systemic mastocytosis
New C96.22 Mast cell sarcoma
New C96.29 Other malignant mast cell neoplasm

Chapter 3: No new codes, but there are some revisions.

Chapter 4: New E11.1 Type 2 diabetes mellitus with ketoacidosis
New E11.10 Type 2 diabetes mellitus with ketoacidosis without coma
New E11.11 Type 2 diabetes mellitus with ketoacidosis with coma

Chapter 5: New F11.11 Opioid abuse, in remission
New F12.11 Cannabis abuse, in remission
New F13.11 Sedative, hypnotic or anxiolytic abuse, in remission
New F15.11 Other stimulant abuse, in remission

Chapter 6: New G12.23 Primary lateral sclerosis
New G12.24 Familial motor neuron disease
New G12.25 Progressive spinal muscle atrophy

Chapter 7: New H44.2B Degenerative myopia with macular hole
New H44.2B1 Degenerative myopia with macular hole, right eye
New H44.2E9 Degenerative myopia with other maculopathy, unspecified eye
New H44.2B2 Degenerative myopia with macular hole, left eye
New H44.2B3 Degenerative myopia with macular hole, bilateral eye
New H44.2B9 Degenerative myopia with macular hole, unspecified eye

Chapter 8: No changes at all to this chapter

Chapter 9: New I21.9 Acute myocardial infarction, unspecified
New I21.A Other type of myocardial infarction
New I21.A1 Myocardial infarction type 2
New I21.A9 Other myocardial infarction type
           (Check out the pulmonary hypertension codes and the Heart Failure codes for FY2018 too.)

Chapter 10: No new codes, but there are some revisions.

Chapter 11: New K56.601 Complete intestinal obstruction, unspecified as to cause
New K56.609 Unspecified intestinal obstruction, unspecified as to partial versus complete obstruction
New K56.690 Other partial intestinal obstruction
New K56.691 Other complete intestinal obstruction
New K56.699 Other intestinal obstruction unspecified as to partial versus complete obstruction

Chapter 12: New L97.115 Non-pressure chronic ulcer of right thigh with muscle involvement without evidence of necrosis
New L97.116 Non-pressure chronic ulcer of right thigh with bone involvement without evidence of necrosis
New L97.118 Non-pressure chronic ulcer of right thigh with other specified severity

Chapter 13: New M33.03 Juvenile dermatomyositis without myopathy
New M33.13 Other dermatomyositis without myopathy
New M33.93 Dermatopolymyositis, unspecified without myopathy

Chapter 14: New N63.0 Unspecified lump in unspecified breast
New N63.1 Unspecified lump in the right breast
New N63.10 Unspecified lump in the right breast, unspecified quadrant
New N63.11 Unspecified lump in the right breast, upper outer quadrant
New N63.12 Unspecified lump in the right breast, upper inner quadrant
New N63.13 Unspecified lump in the right breast, lower outer quadrant
New N63.14 Unspecified lump in the right breast, lower inner quadrant

Chapter 15: New O00.111 Right tubal pregnancy with intrauterine pregnancy
New O00.112 Left tubal pregnancy with intrauterine pregnancy
New O00.119 Unspecified tubal pregnancy with intrauterine pregnancy

Chapter 16: New P29.30 Pulmonary hypertension of newborn
New P29.38 Other persistent fetal circulation

Chapter 17: New Q53.111 Unilateral intraabdominal testis
New Q53.112 Unilateral inguinal testis

Chapter 18: New R06.03 Acute respiratory distress
New R39.83 Unilateral non-palpable testicle
New R39.84 Bilateral non-palpable testicles

Chapter 19: No new codes, but there are several revisions.

Chapter 20: New V86.25 Person on outside of 3- or 4- wheeled all-terrain vehicle (ATV) injured in traffic accident
New V86.26 Person on outside of dirt bike or motor/cross bike injured in traffic accident
New V86.35 Unspecified occupant of 3- or 4- wheeled all-terrain vehicle (ATV) injured in traffic accident
New V86.36 Unspecified occupant of dirt bike or motor/cross bike injured in traffic accident

Chapter 21: New Z71.82 Exercise counseling
New Z71.83 Encounter for nonprocreative genetic counseling

I hope that gives you a flavor of the new codes that we can begin to use Oct. 1.   For some of these diseases and conditions that now have new codes to classify them, it is worthwhile to do some research on the disease and understand the following:

• What is the issue
• How it occurs
• What population is effected
• How it is treated or cured

Basically, you need to learn some clinical information because understanding the disease process is one of the core competencies of a clinical coder and clinical documentation integrity) (CDI) professional.

Don’t forget to contact your coding software vendor to get an update on when the new code set will be loaded and ready to use. Also, check with your own information technology (IT) team to confirm when they will have the update ready for your use.

The above summary of changes is only a quick snap-shot of some of the new codes for FY 2018. Every health information management (HIM) coding professional and CDI professional have the responsibility to update themselves completely on the changes to the code set. 

I really enjoy all the excitement that the new codes bring, as it really draws attention to the clinical coding professional and how valuable they are to our hospitals, clinics and organizations. 

So, let’s enjoy learning all about the new codes in the coming weeks!

PROGRAM NOTE: Hear Gloryanne Bryant discuss the FY 2018 ICD-10-CM code changes live on Talk Ten Tuesdays today at 10 a.m. ET.