Coding: Your ICD-10 Honeymoon Is Over

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article covers the transition from ICD-10 implementation flexibility to stricter claims review, along with the major ICD-10 code changes scheduled to take effect in 2016 and 2017. It is aimed at physicians, coders, and compliance staff who need to understand the scope of the upcoming updates across specialties such as podiatry, otolaryngology, ophthalmology, optometry, and Medicare billing. The discussion focuses on broad categories of code expansion, added specificity, and documentation impacts associated with the new release cycle.

Why This Topic Matters

Readers need to know that the temporary leniency around ICD-10 coding was ending and that many specialties would face more specific reporting requirements under the updated code sets. The article helps practices anticipate coding, documentation, and denial-management changes tied to the annual ICD-10 update process.

Article Sections

  1. CMS ICD-10 grace period ending

    Introduces the end of the temporary flexibility period and frames the shift toward stricter review of ICD-10 claims. Discusses why providers were seeing limited denials and why that environment was changing.

  2. Why there are so many new codes for 2017

    Explains the backlog of ICD-10 updates and the general reasons new and revised codes were being released. Covers broad examples of code expansion and replacement patterns.

  3. Listen Up: New Codes for Hearing Loss & Tinnitus

    Summarizes upcoming ICD-10 changes affecting otolaryngology, with emphasis on more specific diagnosis reporting and documentation needs. Notes the general direction of hearing loss and tinnitus code expansion.

  4. Look Out for Eye Care Codes

    Reviews upcoming ICD-10 changes relevant to ophthalmology and optometry. Covers the broad increase in laterality and specificity for eye-related diagnosis coding.

What You Will Learn

  • How the end of ICD-10 implementation flexibility may affect claims review
  • Why the annual ICD-10 update cycle is producing a large number of new and revised codes
  • Which specialties are most affected by the upcoming code changes
  • What kinds of documentation changes are associated with more specific diagnosis reporting
  • How eye care and hearing-related diagnosis categories are changing at a high level

Who Should Read This

  • Physicians
  • Medical coders
  • Billing staff
  • Compliance staff
  • Practice managers
  • Medicare providers
  • Specialty coders

Codes Discussed

  • ICD-10-CM: K52.2
  • ICD-10-CM: K52.21
  • ICD-10-CM: M20.1
  • ICD-10-CM: H35.31
  • ICD-10-CM: H35.32

Code Ranges Discussed

  • ICD-10-CM: K58.-
  • ICD-10-CM: M20.1-
  • ICD-10-CM: M21.6--
  • ICD-10-CM: H90.A--
  • ICD-10-CM: H93.A-
  • ICD-10-CM: E08.3--
  • ICD-10-CM: E09.3--
  • ICD-10-CM: E10.3--
  • ICD-10-CM: E11.3--

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