Read parts 2 and 3 of this blog for more updates on ICD-10-PCS and Coding Guideline Updates.

ICD-10-CM Coding Updates effective October 1, 2020 (FY 2021)

It is that time of year when the ICD-10-CM and PCS changes are right around the corner. Set to take effect on October 1, 2020 there are numerous updates to Official Coding Guidelines, ICD-10-CM, and ICD-10-PCS. Medical Records Associates will be covering these updates in a multipart blog series. The first of which will review the ICD-10-CM diagnosis code changes for the upcoming year.

Updates that are set to take effect October 1st, 2020 include: 490 new codes, 47 revised codes and 58 deleted or invalid codes. This blog will provide high level key updates for each ICD-10-CM chapter.

Chapter 1: Certain Infectious & Parasitic Disease (A00 – B99): Chapter 1 Official Coding Guidelines provides a new section 1.g for reporting Coronavirus infections. In addition, there are 7 new diagnosis codes and 2 deleted codes. The new codes are added to provide greater specificity with Other Tick-borne illnesses and Babesiosis.

Chapter 2: Neoplasms (C00-D49): There are no additions, revisions, or deletions in this chapter for 2021 coding updates.

Chapter 3: Diseases of Blood & Blood-forming organs (D50-D89): Chapter 3 has 43 new codes, 3 revised, and 3 deleted codes. Eighteen new codes will provide greater specificity when reporting sickle cell anemia and associated complications. Other code changes in this chapter involve autoimmune disorders and anemias.

Chapter 4: Endocrine, Nutritional & Metabolic Disease (E00-E89): Chapter 4 updates includes 6 new codes, 0 revised, and 2 deleted codes. The added codes provide expansion in the aminoacid metabolism disorders as well as glucose transport disorders.

Chapter 5: Mental, Behavioral and Neurodevelopmental Disorders (F01-F99): Chapter 5 contains 21 new codes, 0 revised, and 0 deleted. The new codes all describe the type of withdrawal from substance abuse including alcohol, cocaine, and opioids. For example,
F10.131 is a new code for Alcohol abuse with withdrawal delirium.

Chapter 6: Diseases of the Nervous System (G00-G99): Chapter 6 provides 24 new codes, 0 revised, and 5 deleted codes for the 2021 updates. The updates provide expansion and specificity with congenital myopathies, cerebrospinal fluid leaks, and intracranial hypotension.

Chapter 7: Diseases of the eye and adnexa (H00-H59): Chapter 7 has 29 new codes, 1 revised code, and 5 deleted code updates. The largest majority of changes in this chapter involve new codes to reflect the various types of corneal dystrophy and the laterality of right, left, bilateral, or unspecified eye.

Chapter 8: Diseases of the ear and mastoid process (H60-H95): This Chapter contains no additions, revisions, or deletions for codes.

Chapter 9: Diseases of the Circulatory System (I00-I99) This Chapter contains no additions, revisions, or deletions for codes. There are several coding guideline updates in this chapter that will be covered in a separate blog.

Chapter 10: Diseases of the Respiratory System (J00-J99) Chapter 8 has 6 new codes, 0 revised, and 2 deleted codes. There are also coding guideline updates in this chapter in section 10.e involving vaping-related disorders.

Chapter 11: Diseases of the Digestive System (K00-K95): This chapter has 11 new codes, 0 revised, and 5 deleted codes. The updates involve adding specificity to gastroesophageal reflux disorder to indicate with or without esophagitis and with or without hemorrhage.

Chapter 12: Diseases of the Skin and Subcutaneous Tissue (L00-L99): This Chapter contains no additions, revisions, or deletions this year.

Chapter 13: Musculoskeletal System (M00 -M99): Chapter 13 has 57 new codes, 0 revisions, and 3 deleted codes. This year there are twelve new codes to capture other pathological fractures (M80.8AX- and M80.0AX-). Other new code updates include an expanded list of codes
for rheumatoid arthritis, as well as primary and secondary arthritis, and arthritis caused by trauma. New codes in the M24 category for other articular cartilage disorders, disorders of ligament, pathological dislocation, recurrent dislocation, contracture and ankylosis.

Chapter 14: Disease of Genitourinary (N00-N99): Chapter 14 has 15 new codes, 0 revised, and 1 deleted code. These updates bring two new sub-stages to Stage 3 chronic kidney disease (CKD). The new codes are: N18.30 (Chronic kidney disease, stage 3 unspecified), N18.31
(Chronic kidney disease, stage 3a) and N18.32 (Chronic kidney disease, stage 3b).

Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A): The updates in this chapter include 5 new codes, 0 revised codes, and 1 deleted code. There are several coding guideline updates for this chapter involving Sepsis O85, as well as a new section 15.s that provides instruction on reporting COVID-19 infections in pregnancy, childbirth, and the puerperium.

Chapter 16: Certain Conditions Originating in the Perinatal Period (P00 -P99). Chapter 16 has 4 new codes, 0 revised codes, and 0 deleted codes. The new codes are for neonatal cerebral infarction. There are also updated coding guidelines with a new section 16.h for reporting
COVID-19 Infections in Newborn.

Chapter 17: Congenital Malformations, Deformations, and Chromosomal abnormalities (Q00-Q99): Chapter 17 has 0 new codes, 3 revised, and 1 deleted code in the updates. The code revisions in this chapters all related to congenital doubling of the uterus.

Chapter 18: Symptoms, Signs, and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99). Chapter 18 has 4 new codes, 0 revised and 2 revised codes. Code R51 (Headache) will be split into two codes: R51.0 (Headache with orthostatic component, not
elsewhere classified) or R51.9 (Headache, unspecified).

Chapter 19: Injury, poisoning & certain other consequences (S00-T88): This chapter holds 128 new codes, 0 revised, and 23 deleted coded. There are many new injury, poisoning, and adverse effect codes. For example, poisoning by fentanyl and tramadol as well as other
synthetic narcotics.

Chapter 20: External Causes of morbidity (V00-Y99): This chapter has 125 new codes, 1 revised, and 1 deleted code. The vast majority of the new codes are to provide greater code expansion for pedestrian accidents.

Chapter 21: Factors influencing health status and contact with health services (Z00-Z99). This chapter includes 3 new codes, 39 revised and 0 deleted. The 3 new codes are for observation of suspected ingested, aspirated, or inserted foreign body.

NEW Chapter 22: Codes for Special Purposes (U00-U85): This chapter includes just two codes: U07.0 Vaping- related disorder and U07.1 COVID-19, these codes took effect in the earlier this year.

With these FY 2021 ICD-10-CM Coding Updates — additions, revisions, and deletions that brings the total ICD-10-CM code set to 72,616! Stay tuned for the ICD-10-PCS updates as well as a deeper dive into the Official Coding Guideline changes for 2020.

Reference: https://www.cms.gov/medicare/icd-10/2021-icd-10-cm

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