Coders will have hundreds of new ICD-10-CM codes to report Oct. 1, including codes for sickle cell anemia and arthritis. In addition, they’ll find a series of new options for headache codes.
The proposed FY2021 update will be significantly larger than the FY2020 update if all of the proposed changes go through as planned: 490 new codes, 47 revised codes and 58 invalidated.
Handling headache codes
Practitioners will need to be specific when they code headache as a symptom. ICD-10-CM code R51 (Headache) will be split into two codes according to the proposed code set published in the proposed acute inpatient prospective payment rule today. Their choices will be R51.0 (Headache with orthostatic component, not elsewhere classified) or R51.9 (Headache, unspecified) if the changes go through as planned.
Another source of new headache coding will come from five new codes for intracranial hypotension – the severe orthostatic headache that is a common symptom of a cerebral spinal fluid (CSF) leak: For example, G96.810 (Intracranial hypotension, unspecified), G97.83 (Intracranial hypotension following lumbar cerebrospinal fluid shunting) and G97.84 (Intracranial hypotension following other procedure). You’ll also find five new codes for CSF leaks in place of the current code G96.0 (CSF leak).
Updates to sickle cell anemia, others
The proposed code set also contains 18 new, detailed codes for sickle cell anemia. The new codes specify complications related to the condition such as D57.213 (Sickle-cell/Hb-C disease with cerebral vascular involvement) and D57.431 (Sickle-cell thalassemia beta zero with acute chest syndrome).
Behavioral health specialists who treat substance abuse will find 17 new codes that describe withdrawal from substances including alcohol, cocaine and opioids: For example, F10.932 (Alcohol use, unspecified with withdrawal with perceptual disturbance).
Providers will have an expanded list of codes for rheumatoid arthritis, as well as primary and secondary arthritis, and arthritis caused by trauma. Also, among the 57 new musculoskeletal codes, you’ll find new codes in the M24 category for other articular cartilage disorders, disorders of ligament, pathological dislocation, recurrent dislocation, contracture and ankylosis.
Among 128 additions to Chapter 19 are new codes for adverse effects and poisoning by fentanyl and tramadol as well as other synthetic narcotics.
Proposed FY 2021 ICD-10-CM code changes
|
ICD-10-CM chapter
|
New
|
Revised
|
Invalid
|
|
Chapter 1: Certain infectious and parasitic diseases (A00-B99)
|
7
|
0
|
2
|
|
Chapter 2: Neoplasms (C00-D49)
|
0
|
0
|
0
|
|
Chapter 3: Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)
|
43
|
3
|
3
|
|
Chapter 4: Endocrine, nutritional and metabolic diseases (E00-E89)
|
6
|
0
|
2
|
|
Chapter 5: Mental, Behavioral and Neurodevelopmental disorders (F01-F99)
|
21
|
0
|
0
|
|
Chapter 6: Diseases of the nervous system (G00-G99)
|
24
|
0
|
5
|
|
Chapter 7: Diseases of the eye and adnexa (H00-H59)
|
29
|
1
|
7
|
|
Chapter 8: Diseases of the ear and mastoid process (H60-H95)
|
0
|
0
|
0
|
|
Chapter 9: Diseases of the circulatory system (I00-I99)
|
0
|
0
|
0
|
|
Chapter 10: Diseases of the respiratory system (J00-J99)
|
6
|
0
|
2
|
|
Chapter 11: Diseases of the digestive system (K00-K95)
|
11
|
0
|
5
|
|
Chapter 12: Diseases of the skin and subcutaneous tissue (L00-L99)
|
0
|
0
|
0
|
|
Chapter 13: Diseases of the musculoskeletal system and connective tissue (M00-M99)
|
57
|
0
|
3
|
|
Chapter 14: Diseases of the genitourinary system (N00-N99)
|
15
|
0
|
1
|
|
Chapter 15: Pregnancy, childbirth and the puerperium (O00-O9A)
|
5
|
0
|
1
|
|
Chapter 16: Certain conditions originating in the perinatal period (P00-P96)
|
4
|
0
|
0
|
|
Chapter 17: Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
|
0
|
3
|
1
|
|
Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
|
4
|
0
|
2
|
|
Chapter 19: Injury, poisoning and certain other consequences of external causes (S00-T88)
|
128
|
0
|
23
|
|
Chapter 20: External causes of morbidity (V00-Y99)
|
125
|
1
|
1
|
|
Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)
|
3
|
39
|
0
|
|
*Chapter 22: Codes for special purposes (U00-U85)
|
2
|
0
|
0
|
|
Total
|
490
|
47
|
58
|
*New chapter