What radiologists need to know about upcoming ICD-10 changes

By Rebecca Farrington, AuntMinnie.com contributing writer

October 29, 2019 -- The 2020 annual update to the ICD-10-CM1 system used in medical insurance claim billing became effective on October 1, with 21 codes deleted, 30 codes revised, and 273 new codes added. The good news for radiologists is that relatively few of these changes will affect your work.

Rebecca Farrington
Rebecca Farrington from Healthcare Administrative Partners.

The guidelines for use of the system include a general warning not to use terms that convey uncertainty, such as "probable," "suspected," "questionable," "rule out," or "working diagnosis." To this list have been added the terms "compatible with" and "consistent with."

The codes that have been deleted fall into the following categories:

  • Vertigo
  • Atrial fibrillation
  • Congenital conditions
  • Ehlers-Danlos syndrome
  • Adenosine deaminase (ADA) deficiency
  • Heatstroke or sunstroke

If a patient exam is presented with the need to use a diagnosis code in one of these areas, further investigation into the coding should be made. Otherwise, you do not need to worry about using outdated codes.

Unspecified lump in the breast, overlapping quadrants
Right breast N63.15
Left breast N63.25
Post endometrial ablation syndrome N99.85

New codes have been added for reporting in the circulatory system:

Phlebitis and thrombophlebitis of the following:
Right peroneal vein 180.241
Left peroneal vein 180.242
Peroneal vein, bilateral 180.243
Unspecified peroneal vein 180.249
 
Right calf muscular vein 180.251
Left calf muscular vein 180.252
Calf muscular vein, bilateral 180.253
Unspecified calf muscular vein 180.259
Acute embolism and thrombosis of the following:
Right peroneal vein 182.451
Left peroneal vein 182.452
Peroneal vein, bilateral 182.453
Unspecified peroneal vein 182.459
 
Right calf muscular vein 182.461
Left calf muscular vein 182.462
Calf muscular vein, bilateral 182.463
Unspecified calf muscular vein 182.469

Twenty-five codes were added to describe various fractures of the orbit or orbital roof:

Fractures of the orbit or orbital roof
Fracture of orbital roof Left side Right side Unspecified side
Initial encounter for closed fracture S02.122A S02.121A S02.129A
Initial encounter for open fracture S02.122B S02.121B S02.129B
Subsequent encounter for routine healing S02.122D S02.121D S02.129D
Subsequent encounter for fracture with delayed healing S02.122G S02.121G S02.129G
Subsequent encounter for fracture with nonunion S02.122K S02.121K S02.129K
Sequela S02.122S S02.121S S02.129S
Fracture of orbit, unspecified side
Initial encounter for closed fracture S02.85XA
Initial encounter for open fracture S02.85XB
Subsequent encounter for routine healing S02.85XD
Subsequent encounter for fracture with delayed healing S02.85XG
Subsequent encounter for fracture with nonunion S02.85XK
Sequela S02.85XS
Fracture of lateral orbital wall, unspecified side, sequela S02.849S

Finally, seven codes were added to describe the types of Ehlers-Danlos syndrome and other congenital conditions to replace some of the deleted codes.

Generally of greater impact than the ICD coding changes is the annual revision of the current procedural terminology (CPT) system that takes effect at the beginning of each year. Watch for our full coverage of the important coding changes for radiology. Subscribe to the Healthcare Administrative Partners blog to keep abreast of these issues and other news that affect your practice.

1ICD stands for International Classification of Diseases, the system owned and copyrighted by the World Health Organization that is used to report diagnoses when submitting claims for reimbursement of physician services, among many other purposes. ICD-10 is the 10th edition of this coding system. CM stands for the Clinical Modification of the classification system.

Rebecca Farrington serves as the chief revenue officer for Healthcare Administrative Partners. She has more than 20 years of experience in healthcare sales and management roles, focusing on hospital-based and physician revenue cycle management.

The comments and observations expressed are those of the author and do not necessarily reflect the opinions of AuntMinnie.com.


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