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NAMAS: What You Need to Know About 2017 ICD-10 Updates

By:  Find-A-Code
Published:  July 19th, 2016

October 2016 brought us the implementation of ICD-10-CM. The switch from ICD-9-CM to ICD-10-CM brought with it a level of uncertainty and maybe even a little panic. With a great deal of preparation and planning in place, the implementation came and went without too much trouble. Now that we've settled into the world of ICD-10 and have become more comfortable with our new surroundings, we must now look toward the future and prepare for even more change.
A partial code freeze was put into place in 2012, allowing for an easier transition from ICD-9 to ICD-10. Code changes were limited to only capturing new technologies and diseases. As we come to the end of our first fiscal year of using ICD-10, the partial code freeze is also coming to an end and the scene is set for significant changes in the 2017 code set. The Centers for Disease Control and Prevention (CDC) have released the proposed changes that will increase the total number of ICD-10 codes from 69,823 in the 2016 set to 71,486 in the 2017 set. It includes 1974 new codes, 425 revised codes and 311 deleted codes. These changes will be in effect for patient encounters occurring from October 1, 2016 through September 30, 2017.
With the Zika virus outbreak making headlines around the world, one of the more notable October additions to the ICD-10 code set is the new Zika virus disease code. Here is a quick look at some of the new codes: 
A92.5 Zika virus disease Zika virus fever
Zika virus infection
Zika NOS

C49.A0 Gastrointestinal stromal tumor, unspecified site
C49.A1 Gastrointestinal stromal tumor of esophagus
C49.A2 Gastrointestinal stromal tumor of stomach
C49.A3 Gastrointestinal stromal tumor of small intestine
C49.A4 Gastrointestinal stromal tumor of large intestine
C49.A5 Gastrointestinal stromal tumor of rectum
C49.A9 Gastrointestinal stromal tumor of other site

D47.Z2 Castleman disease 
Code also if applicable: human herpesvirus 8 infection (B10.89)
Excludes: Kaposi's sarcoma (C46-)

E08.32 Diabetes mellitus due to underlying condition with mild nonprolifeerative diabetic retinopathy
One of the following 7th characters is to be assigned to codes in subcategory E08.32 to designate laterality of the disease:
1 right eye
2 left eye
3 bilateral
9 unspecified eye

F32.81 Premenstrual dysphoric disorder Excludes: premenstrual tension syndrome (N94.3)

H34.81 Central retinal vein occlusion One of the following 7th characters is to be assigned to codes in subcategory H34.81 to designate the severity of the occlusion:
0 with macular edema
1 with retinal neovascularization
2 stable
K08.89 Other specified disorders of teeth and supporting structures Enlargement of alveolar ridge NOS
Insufficient anatomic crown height
Insufficient clinical crown length
Irregular alveolar process
Toothache NOS

L76.3 Postprocedural hematoma and seroma of skin and subcutaneous tissue following a procedure L76.31 Postprocedural hematoma of skin and subcutaneous tissue following a dermatologic procedure
L76.32 Postprocedural hematoma of skin and subcutaneous tissue following other procedure
L76.33 Postprocedural seroma of skin and subcutaneous tissue following a dermatologic procedure
L76.34 Postprocedural seroma of skin and subcutaneous tissue following other procedure

M21.61 Bunion M21.611 Bunion of right foot
M21.612 Bunion of left foot
M21.619 Bunion of unspecified foot

N50.81 Testicular pain N50.811 Right testicular pain
N50.812 Left testicular pain
N50.819 Testicular pain, unspecified

O33.7 Maternal care for disproportion due to other fetal deformities One of the following 7th characters is to be assigned to code O33.7. 7th character 0 is for single gestations and multiple gestations where the fetus is unspecified. 7th characters 1 through 9 are for cases of multiple gestations to identify the fetus for which the code applies. The appropriate code from category O30, multiple gestation, must also be assigned when assigning code O33.7 with a 7th character of 1 through 9
0 not applicable or unspecified
1 fetus 1
2 fetus 2
3 fetus 3
4 fetus 4
5 fetus 5
9 other fetus
Q25.4 Other congenital malformations of aorta Q25.40 Congential malformation of aorta unspecified
Q25.41 Absence and aplasia of aorta
Q25.42 Hypoplasia of aorta
Q25.43 Congenital aneurysm of aorta
             Congenital aneurysm of aortic root
             Congenital anerysm of aortic sinus
Q25.44 Congenital dialation of aorta
Q25.45 Double aortic arch
             Vascular ring of aorta
Q25.46 Tortuous aortic arch
             Persistent convolutions of aortic arch
Q25.47 Right aortic arch
             Persistent right aortic arch
Q25.48 Anomalous origin of subclavian artery
Q25.49 Other congenital malformations of aorta

S02.10 Unspecified fracture of base of skull S02.101 Fracture of base of skull, right side
S02.102 Fracture of base of skull, left side
S02.109 Fracture of base of skull, unspecified side

Z30.01 Encounter for initial prescription of contraceptives Z30.015 Encounter for initial prescription of vaginal ring hormonal contraceptive
Z30.016 Encounter for initial prescription of transdermal patch hormonal contraceptive device
Z30.017 Encounter for initial prescription of implantable subdermal contraceptive  
In addition to all of the new, revised, and deleted codes, CMS is ending its "right family" forgiveness. During this year of transition, CMS allowed for some flexibility and didn't penalize the provider for reporting a code that is not to the highest degree of specificity as long as the code is in the right family. The code family is the ICD-10 three character category; codes within these categories are clinically related. However, starting October 1, 2016 CMS will no longer provide this flexibility and it will be imperative for practices to document and code to the highest degree of specificity.

For more information and a complete list of new, revised and deleted codes, please visit the CMS website: https://www.cms.gov/Medicare/Coding/ICD10/2017-ICD-10-CM-and-GEMs.html
 
This Week's Audit Tip
Provided by:
 
Jessica Franzese, CPC, CPMA
Jessica serves as an Auditing Specialist within the Department of Audit and Regulatory Compliance for our parent organization, DoctorsManagement, LLC.

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