Code Updates are Coming: What’s Changing?

Chapter 1: Certain Infectious and Parasitic Diseases

1 addition, 1 deletion

• A4154 Sepsis due to Acinetobacter baumannii
• B9693 Acinetobacter baumannii as the cause of disease classified elsewhere

Chapter 2:  Neoplasms

21 additions, 2 deletions

• Added new codes regarding Desmoid tumors
• Deletions are due to the expansion of codes to allow for more specificity.

Chapter 4: Endocrine, Nutritional, and Metabolic Diseases

18 additions, 3 deletions

• Clarified codes by adding fifth and sixth digits, eliminating the broader four-digit codes. Added new codes for Pelizaeus-Merzbacher, Canavan, and Wasting disease (syndrome) due to an underlying condition.
• Deletions are again due to the expansion of codes to allow for more specificity.

Chapter 6:  Disease of the Nervous System

24 additions, 2 deletions

• New codes relate to Parkinson’s disease without and without dyskinesia and with or without fluctuations. Parkinson’s, unspecified is now code G20C.  Other new codes relate to Hypomyelination with atrophy of basal ganglia, Leukodystrophy, Alexander disease, Lafora progressive myoclonus epilepsy, Chronic migraines, Megalencephalic, and leukoencephalopathy.
• Deletions are again due to the expansion of codes to allow for more specificity.

Chapter 7:  Diseases of the Eye and Adnexa

34 additions, 1 deletion

• New codes are primarily related to sickle-cell-related retinopathy. Entrapment codes have been expanded to designate the specific muscle and laterality of the eye, as well as some additions related to foreign body sensation.
• Deletions are again due to the expansion of codes to allow for more specificity.

Chapter 9:  Diseases of the Circulatory System

10 additions, 3 deletions, and 10 revisions.

• New codes related to other forms of Angina Pectoris with specificity, MI with coronary microvascular dysfunction, other forms of acute ischemic heart disease, and expansion for specificity to supraventricular tachycardia.
• Deletions are again due to the expansion of codes to allow for more specificity.

Chapter 10:  Diseases of the Respiratory System

7 additions, 1 deletion

• New codes related to Pneumonia due to Acinetobacter baumannii, gram-negative bacteria, Bronchiolitis obliterans and syndrome, other specified COPD, restrictive allograft syndrome, other and unspecified Chronic lung allograft dysfunctions.
• Deletions are again related to code expansion for specificity.

Chapter 11: Digestive

17 additions, 2 deletions

• New codes related to acute appendicitis with generalized peritonitis with and without perforations, abscesses, or unspecified. Small intestinal bacterial overgrowth with specificity for bacteria, Retroperitoneal fibrosis and hematoma, short bowel syndrome, and intestinal failure.
• Deletions are again related to code expansion for specificity.

Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue

36 additions

• Chapter with the second most changes. Osteoporosis, aged-related or other, with laterality specificity and unspecified pelvis are new codes.

Chapter 14: Diseases of the Genitourinary System

15 additions, 2 deletions, and 1 revision

• New codes are related to Recurrent and persistent immunoglobulin A with specificity, Nephrotic syndrome with diffuse membranous glomerulonephritis, Primary and secondary membranous nephropathy, Other nephrotic syndromes, and Isolated proteinuria with specificity.
• Deletions are again related to code expansion for specificity.

Chapter 15: Childbirth, Pregnancy, and Puerperium

6 additions, 1 deletion

• New codes are related to Intrahepatic cholestasis of pregnancy, specified by trimester; Hepatorenal syndrome following labor and delivery, and other postpartum acute kidney failures.
• Deletion is for Postpartum acute kidney failure.

Chapter 16: Conditions Originating in the Perinatal Period

1 revision

• Revise from: P199 Metabolic acidemia, unspecified.
• Revise to: P199    Metabolic acidemia in newborn, unspecified

Chapter 17:  Congenital Malformations, Deformations, and Chromosomal Abnormalities

22 additions, 2 deletions, and 6 revisions

• New codes are for congenital malformations of liver, Alagille syndrome, Craniosynostosis, Coronal craniosynostosis, Metopic craniosynostosis and Lambdoid specificity by laterality. Cloverleaf skull, Pansynostosis, single and multiple suture craniosynostosis. Bardet-Biedl, Laurence-Moon, MED13L, and Phelan-McDermid syndromes.
• Deletions are again related to code expansion for specificity.
• Revisions are related to PTEN tumor and Marfan’s Syndrome, all revised to all for further specificity.

Chapter 18:  Signs and Symptoms

18 additions

• New codes related to Foreign body sensations specifications, Nontraumatic coma, Dense breasts, Mammographic fatty tissue, fibro glandular, heterogeneous and extreme densities with a specificity of laterality.

Chapter 19: Injury and Poisoning

12 additions

• All new codes relate to the toxic effects of gadolinium

Chapter 20: External Cause of Morbidity

123 additions

• Chapter with the largest updates and new codes. The new codes relate to foreign bodies, including button batteries, plastic objects, glass, magnetic metal, non-magnet, rubber bands, food, non-organic items, and sharp items entering the body.

Chapter 21:  Factors Influencing Health Status and Contact with Health Services

30 additions, 6 deletions

• New codes relate to the observation of newborns for suspected conditions ruled out, carrier of Acinetobacter baumannii bacteria, encounter for prophylactic measures, family history of specific colon polyps, and caregiver’s non-compliance type. The Social Determinants of Health (see paragraph one) have also been enhanced, with new codes for child custody and parental/adult-child conflict.
• Deletions are again related to code expansion for specificity.

How CSI Can Help

Keep in mind that documentation relating to Official Guidelines for Coding and Reporting has yet to be released. That clarification will come later.

Stay in touch with CSI for further information and education related to both the Official Guidelines and Code Updates. We would love to assist you in training your coders! Please email hello@csicompanies.com for more information.

By: Lou Ann Wiedemann

Director Provider Coding, MS, FAHIMA, RHIA, CHDA, CDIP

Connect with Lou Ann on LinkedIn!