by Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Jun 29th, 2017
The new proposed 2018 ICD-10-CM codes have been announced and are to be used for discharges occurring from October 1st, 2017 through September 30th, 2018 and for patient encounters occurring from October 1st, 2017 through September 30th, 2018.
The 2018 General Equivalence Mappings (GEMs) will be available in August 2017. The 2018 ICD-10-CM guidelines, POA Exempt Codes, and Conversion table will be posted from CMS later, once they are finalized and received from CDC.
PCS has also seen some changes and updates for FY 2018. These were released in May 2017. The 2018 ICD-10-PCS codes are to be used for discharges occurring from October 1st, 2017 through September 30th, 2018.
Be sure to verify all of your codes before October 1st, 2017 as there has been some revisions, and in the Table of Drugs and Chemicals there have been a few changes there as well.
There have been some changes with heart failure classification with added notes and revisions in the wording on some of the codes.
There are some different codes added such as G89.13: "Breakthrough pain, a new classification of pain."
There are a few common codes that have added additional characters that you need to be aware of for 2018. For example, the category for K35 Acute appendicitis has made a few changes to distinguish more clearly the severity of acute appendicitis.
K35.21 Acute appendicitis with generalized peritonitis, with abscess
K35.30 Acute appendicitis with localized peritonitis, without perforation or gangrene
Acute appendicitis with localized peritonitis NOS
K35.31 Acute appendicitis with localized peritonitis and gangrene, without perforation
K35.32 Acute appendicitis with perforation and localized peritonitis, without abscess
(Acute) appendicitis with perforation NOS
K35.33 Acute appendicitis with perforation and localized peritonitis, with abscess (Acute)
appendicitis with (peritoneal) abscess NOS Ruptured appendix with localized peritonitis and abscess
K35.890 Other acute appendicitis without perforation or gangrene
K35.891 Other acute appendicitis without perforation, with gangrene
(Acute) appendicitis with gangrene NOS
There are a several new encounter codes. One is a proposed new code for rehabilitation; rehab admits will be recorded with Z51.82: "Encounter for rehabilitation services."
In addition, there are several screening codes added in factors influencing health status and contact with health services (Z00-Z99). More specifically, the changes are related to “Persons encountering health services in circumstances related to reproduction in the Z36 series”.
Z36.0 Encounter for antenatal screening for chromosomal anomalies
Z36.1 Encounter for antenatal screening for raised alphafetoprotein level
Z36.2 Encounter for other antenatal screening follow-up
Z36.3 Encounter for antenatal screening for malformations
Z36.4 Encounter for antenatal screening for fetal growth retardation
Z36.5 Encounter for antenatal screening for isoimmunization
Z36.801 Encounter for antenatal screening for hydrops fetalis
Z36.812 Encounter for antenatal screening for nuchal translucency
Z36.823 Encounter for fetal screening for congenital cardiac abnormalities
Z36.834 Encounter for antenatal screening for fetal lung maturity
Z36.845 Encounter for antenatal screening for Streptococcus B
Z36.856 Encounter for antenatal screening for cervical length
Z36.867 Encounter for antenatal screening for uncertain dates
Z36.878 Encounter for antenatal screening for fetal macrosomia
Z36.889 Encounter for other specified antenatal screening
Z36.8A Encounter for antenatal screening for other genetic defects
Z36.9 Add Encounter for antenatal screening, unspecified
Diseases of the eye and adnexa (H00-H59) seen a few changes as well.
H01.00A Unspecified blepharitis right eye, both eyelids
H01.00B Unspecified blepharitis left eye, both eyelids
H01.01A Ulcerative blepharitis right eye, both eyelids
H01.01B Ulcerative blepharitis left eye, both eyelids
H01.02A Squamous blepharitis right eye, both eyelids
H01.02B Squamous blepharitis left eye, both eyelids
This list is not all of the proposed new codes; however, here are several miscellaneous NEW Codes to watch for:
M25.3A1 Other instability, right temporomandibular joint
M25.3A2 Other instability, left temporomandibular joint
M25.3A9 Other instability, unspecified temporomandibular joint
M25.4A Effusion, temporomandibular joint
M25.4A1 Effusion, right temporomandibular joint
M25.4A2 Effusion, left temporomandibular joint
M25.4A9 Effusion, unspecified temporomandibular joint
M25.5A Pain, temporomandibular joint
M25.5A1 Pain, right temporomandibular joint
M25.5A2 Pain, left temporomandibular joint
M25.5A9 Pain, unspecified temporomandibular joint
M25.6A Stiffness of temporomandibular joint, not elsewhere classified
M25.6A1 Stiffness of right temporomandibular joint, not elsewhere classified
M25.6A2 Stiffness of left temporomandibular joint, not elsewhere classified
M25.6A9 Stiffness of unspecified temporomandibular joint,not elsewhere classified
M26.61 Adhesions and ankylosis of temporomandibular joint
M26.611 Adhesions and ankylosis, right temporomandibular joint
M26.612 Adhesions and ankylosis, left temporomandibular joint
M26.619 Adhesions and ankylosis, unspecified temporomandibular joint
M26.62 Arthralgia of temporomandibular joint
M26.621 Arthralgia, right temporomandibular joint
M26.622 Arthralgia, left temporomandibular joint
M26.629 Arthralgia, unspecified temporomandibular joint
M26.63 Articular disc disorder of temporomandibular joint
M26.631 Articular disc disorder, right temporomandibular joint
M26.632 Articular disc disorder, left temporomandibular joint
M26.639 Articular disc disorder, unspecified temporomandibular joint
M26.64 Arthritis of temporomandibular joint
M26.641 Arthritis, right temporomandibular joint
M26.642 Arthritis, left temporomandibular joint
M26.649 Arthritis, unspecified temporomandibular joint
H05.27 Exophthalmos associated with thyroid disease
Add Code first underlying thyroid disorder (E00-E07)
H05.271 Exophthalmos associated with thyroid disease, right eye
H05.272 Exophthalmos associated with thyroid disease, left eye
H05.273 Exophthalmos associated with thyroid disease, bilateral eye
H05.279 Exophthalmos associated with thyroid disease, unspecified eye
N35.016 Post-traumatic urethral stricture, male, overlapping sites
N35.116 Postinfective urethral stricture, not elsewhere classified, male, overlapping sites
N35.81 Other urethral stricture, male
N35.811 Other urethral stricture, male, meatal
N35.812 Other urethral bulbous stricture, male
N35.813 Other membranous urethral stricture, male,
N35.814 Other anterior urethral stricture, male, anterior
N35.816 Other urethral stricture, male overlapping sites
N35.819 Other urethral stricture, male, unspecified site
N35.82 Other urethral stricture, female
N35.91 Urethral stricture, unspecified, male
N35.911 Unspecified urethral stricture, male, meatal
N35.912 Unspecified bulbous urethral stricture, male
N35.913 Unspecified membranous urethral stricture, male
N35.914 Unspecified anterior urethral stricture, male
N35.916 Unspecified urethral stricture, male, overlapping sites
N35.919 Unspecified urethral stricture, male, unspecified site
Add Pinhole meatus NOS
Add Urethral stricture NOS
N35.92 Unspecified urethral stricture, female
N99.116 Postprocedural urethral stricture, male, overlapping sites
T79.81 Non-healing traumatic wound
Slow-healing traumatic wound
T81.84 Non-healing surgical wound
Slow-healing surgical wound
Code first if applicable fracture requiring surgery with delayed healing (S02.-, S12.-, S22.-, S32.-, S42.-, S62.-, S92.-, with seventh character G; S52.-, S72.-, S82.- with seventh character G, H, or J)
Deleted Codes:
F68.12 Factitious disorder with predominantly physical signs and symptoms
F68.13 Factitious disorder with predominantly physical signs and symptoms imposed on self
S63.13 Subluxation and dislocation of proximal interphalangeal joint of thumb
S63.131 Subluxation of proximal interphalangeal joint of right thumb
S63.132 Subluxation of proximal interphalangeal joint of left thumb
S63.133 Subluxation of proximal interphalangeal joint of unspecified thumb
S63.134 Dislocation of proximal interphalangeal joint of right thumb
S63.135 Dislocation of proximal interphalangeal joint of left thumb
S63.136 Dislocation of proximal interphalangeal joint of unspecified thumb
S63.14 Subluxation and dislocation of distal interphalangeal joint of thumb
S63.141 Subluxation of distal interphalangeal joint of right thumb
S63.142 Subluxation of distal interphalangeal joint of left thumb
S63.143 Subluxation of distal interphalangeal joint of unspecified thumb
S63.144 Dislocation of distal interphalangeal joint of right thumb
S63.145 Dislocation of distal interphalangeal joint of left thumb
S63.146 Dislocation of distal interphalangeal joint of unspecified thumb
References/Resources
About Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Christine Woolstenhulme, CPC, QCC, CMCS, CMRS, is a Certified coder and Medical Biller with 30 years of experience in the healthcare industry.