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ICD-10-CM Changes Released

Source: Emily Hill, PA, AAPM Coding Consultant

The ICD-10-CM update for 2019 became effective October 1, 2018. The 2019 edition contains 279 additions, 51 deletions and 143 revisions for a total of 71,932 ICD-10-CM codes. The ICD-CM code set in the United States is maintained by the ICD Coordination and Maintenance Committee. This committee includes representatives from the National Center for Health Statistics (NCHS) and the Centers for Medicare and Medicaid Services (CMS). This committee reviews all requests for changes or additions to the code set. The Director of NCHS and the Administrator of CMS make the final coding data set decisions. Changes become effective October 1 of each year. A grace period for implementing new ICD codes is not provided.

The ICD Coordination and Maintenance Committee approved the following changes of interest to Pain Medicine providers:

Subcategory M79.1 (Myalgia) has been expanded to include the following more specific codes:

  • M7910 Myalgia, unspecified site
  • M7911 Myalgia of mastication muscle
  • M7912 Myalgia of auxiliary muscles, head and neck
  • M7918 Myalgia, other site

Two new codes were added to indicate cannabis withdrawal:

  • F1223 Cannabis dependence with withdrawal
  • F1293 Cannabis use, unspecified with withdrawal

Subcategory T81.4-(Infection following a procedure) has been expanded to more specifically indicate the site of the infection. Each subcategory includes a 7th character extension indicating the episode of care. As a reminder, 7th character "A" is used for active treatment of the condition. It should be used if the condition is being actively treated regardless of whether the patient has been seen prior to the encounter by either the treating provider or another provider. The new codes are:

  • T8140XA Infection following a procedure, unspecified, initial encounter
  • T8140XD Infection following a procedure, unspecified, subsequent encounter
  • T8140XS Infection following a procedure, unspecified, sequela
  • T8141XA Infection following a procedure, superficial incisional surgical site, initial encounter
  • T8141XD Infection following a procedure, superficial incisional surgical site, subsequent encounter
  • T8141XS Infection following a procedure, superficial incisional surgical site, sequela
  • T8142XA Infection following a procedure, deep incisional surgical site, initial encounter
  • T8142XD Infection following a procedure, deep incisional surgical site, subsequent encounter
  • T8142XS Infection following a procedure, deep incisional surgical site, sequela
  • T8143XA Infection following a procedure, organ and space surgical site, initial encounter
  • T8143XD Infection following a procedure, organ and space surgical site, subsequent encounter
  • T8143XS Infection following a procedure, organ and space surgical site, sequela
  • T8144XA Sepsis following a procedure, initial encounter
  • T8144XD Sepsis following a procedure, subsequent encounter
  • T8144XS Sepsis following a procedure, sequela
  • T8149XA Infection following a procedure, other surgical site, initial encounter
  • T8149XD Infection following a procedure, other surgical site, subsequent encounter
  • T8149XS Infection following a procedure, other surgical site, sequela

A new subcategory has been added for screening for depression and behavioral health disorders. New code Z13.31 should be reported for administration and interpretation of a PHQ-9 or the equivalent. The code should not be used for patients who have an established diagnosis of depression. The new subcategory and codes are:

  • Z13.31 Encounter for screening for depression
  • Z13.32 Encounter for screening for maternal depression
  • Z13.39 Encounter for screening examination for other mental health and behavioral disorders

Practice management and electronic health record systems should automatically update the code set for use on October 1, 2018. There may be other code changes that may be of limited interest. The information on new codes and guideline revisions can be accessed at: www.cms.gov/Medicare/Coding/ICD10/2019-ICD-10-CM.html.

At the bottom of the page, select the download titled "2019 Addendum" for the additions and deletions. You can also access the complete set of code descriptors by selecting "2019 Code Descriptors in Tabular Order".

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