2018 ICD-10-CM Codes Announced

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

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