ICD-10-CM FY2021 CODING UPDATE OVERVIEW
Post written by Gloryanne Bryant, RHIA, CDIP, CCS, CCDS, AHIMA Approved ICD-10- CM/PCS Trainer.
Starting October 1st, 2020, we will have 490 new, 47 revised, and 58 invalid/deleted ICD-10-CM codes. That’s quite a large amount of new codes for FY2021, and changes, so lots to grasp and fully understand. Let’s briefly walk through each chapter at a high-level in this blog. We will go into more detail during our September webinar on the ICD-10-CM FY2021 Changes being held on 9/23/2020, and cover all “new” codes, so be sure to attend – register:
Chapter 1: Certain Infectious & Parasitic Disease (A00-B99)
There are a total of seven (7) new codes in this Chapter:
NEW A84.81 Powassan virus disease
NEW A84.89 Other tick-borne viral encephalitis
AND
NEW B60.00 Babesiosis, unspecified
NEW B60.01 Babesiosis due to Babesia microti
NEW B60.02 Babesiosis due to Babesia duncani
NEW B60.03 Babesiosis due to Babesia divergens
NEW B60.09 Other babesiosis
Babesiosis is caused by microscopic parasites that infect red blood cells and are spread by certain ticks. In the United States, tickborne transmission is most common in certain regions and seasons: it mainly occurs in parts of the Northeast and upper Midwest and usually peaks during the warm months.
Chapter 2: Neoplasms (C00-D49)
There are some minor revisions within this Chapter but -0- new codes.
Chapter 3: Diseases of Blood & Blood-forming organs (D50-D89)
There are eighteen new, detailed codes available for sickle cell anemia without major complications in crisis. There is also an expansion of codes for Temperature-Sensitive Acquired Autoimmune Hemolytic Anemias (AIHA) to differentiate the 4 types.
Chapter 4: Endocrine, Nutritional & Metabolic Disease (E00-E89)
Changes in this Chapter include the following new codes:
NEW D72.10 Eosinophilia, unspecified
NEW D72.11 Hypereosinophilic syndrome [HES]
NEW D72.110 Idiopathic hypereosinophilic syndrome [IHES]
NEW D72.111 Lymphocytic Variant Hypereosinophilic Syndrome [LHES]
NEW D72.118 Other hypereosinophilic syndrome
NEW D72.119 Hypereosinophilic syndrome [HES], unspecified
Chapter 5: Mental, Behavioral and Neurodevelopmental Disorders (F01-F99)
This chapter contains twenty-one new codes that describe withdrawal from substances including alcohol, cocaine, and opioids. For example, F10.93 Alcohol use, unspecified with withdrawal with perceptual disturbance.
Chapter 6: Diseases of the Nervous System (G00-G99)
The coding classification system has added “pseudotumor” as a clarifying term to G93.2 (Benign intracranial hypertension) and coding professionals are instructed to code G98.81- (intracranial hypotension) with G96.0 (Cerebrospinal fluid leak) when applicable.
Chapter 7: Diseases of the eye and adnexa (H00-H59)
Several new codes to specifically identify complications of corneal transplant will be available for FY2021.
Chapter 8: Diseases of the ear and mastoid process (H60-H95)
No new, revised, or deleted codes for FY2021.
Chapter 9: Diseases of the circulatory system (I00-I99)
Changes to codes I70.22-I70.24 was made, adding “Includes” to each of these codes:
chronic limb-threatening ischemia NOS of native arteries of extremities
chronic limb-threatening ischemia of native arteries of extremities with rest pain
critical limb ischemia NOS of native arteries of extremities
critical limb ischemia of native arteries of extremities with rest pain
Chapter 10: Diseases of the respiratory system (J00-J99)
Research is being done on pulmonary eosinophilia and COVID-19, as there are reported cases of this with the virus, so these new codes are relevant.
NEW J82.8 Pulmonary eosinophilia, not elsewhere classified
NEW J82.81 Chronic eosinophilic pneumonia
NEW J82.82 Acute eosinophilic pneumonia
NEW J82.83 Eosinophilic asthma
NEW J82.89 Other pulmonary eosinophilia, not elsewhere classified
Also, in this chapter are two new codes to capture interstitial lung disease/pulmonary fibrosis.
Chapter 11: Diseases of the digestive system (K00-K95)
In this chapter there are new codes to identify esophagitis and gastro-esophageal reflux with and without bleeding. In addition, hepatic fibrosis has three (3) new codes:]
NEW K74.00 Hepatic fibrosis, unspecified
NEW K74.01 Hepatic fibrosis, early fibrosis
NEW K74.02 Hepatic fibrosis, advanced fibrosis
Chapter 12: Diseases of the skin and subcutaneous tissue (L00-L99)
Codes L57 and L98.4 have revisions for FY2021, but no new codes or deletions.
Chapter 13: Diseases of the musculoskeletal system and connective tissue (M00-M99)
There are many new codes for chapter 13 this year. M05.7A-M05.8A relating to Rheumatoid Arthritis. Also, this year we have new codes for M08 section regarding Juvenile arthritis and M19, Primary Osteoarthritis. There were new codes added for specific joint derangements at the M24.1 Other articular cartilage disorders code level. Several new codes at M26.6 level relating to Arthritis and Arthropathy of temporomandibular joint.
Chapter 14: Diseases of the genitourinary system (N00-N99)
The range of N00.A-N07.A captures nephritic syndrome with C3 glomerulonephritis, acute, rapidly progressive, recurrent, and persistent.
Three (3) new codes from CKD stage 3, these are important to understand and really review the documentation carefully. Clinical Stage 3 is subdivided, so now the coding classification system capture this with these codes.
NEW N18.30 Chronic kidney disease, stage 3 unspecified
NEW N18.31 Chronic kidney disease, stage 3a
NEW N18.32 Chronic kidney disease, stage 3b
Chapter 15: Pregnancy, childbirth, and the puerperium (O00-O9A)
Under code O34.21 Maternal care for scar from previous cesarean delivery are two new codes:
NEW O34.218 Maternal care for other type scar from previous cesarean delivery Mid-transverse T incision
NEW O34.22 Maternal care for cesarean scar defect (isthmocele)
Also new under O99.89 Other specified diseases and conditions complicating pregnancy, childbirth and the puerperium are these codes:
NEW O99.891 Other specified diseases and conditions complicating pregnancy
NEW O99.892 Other specified diseases and conditions complicating childbirth
NEW O99.893 Other specified diseases and conditions complicating puerperium
Chapter 16: Certain conditions originating in the perinatal period (P00-P96)
Under code P91.8 Other specified disturbances of cerebral status of newborn there has been several new codes to classify neonatal cerebral infarction:
NEW P91.82 Neonatal cerebral infarction
NEW P91.821 Neonatal cerebral infarction, right side of brain
NEW P91.822 Neonatal cerebral infarction, left side of brain
NEW P91.823 Neonatal cerebral infarction, bilateral
NEW P91.829 Neonatal cerebral infarction, unspecified side
Chapter 17: Congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
For FY2021 there are some deletions and revision made for the condition “Other doubling of uterus”.
Chapter 18: Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
There are four (4) new codes in this chapter; two relating to headache and two relating to cc:
NEW R51.0 Headache with orthostatic component, not elsewhere classified
NEW R51.9 Headache, unspecified
NEW R74.01 Elevation of levels of liver transaminase levels
NEW R74.02 Elevation of levels of lactic acid dehydrogenase [LDH]
Chapter 19: Injury, poisoning, and certain other consequences of external causes (S00-T88)
New codes were developed to capture “Contusion of front wall of thorax” and “Unspecified superficial injuries of front wall of thorax”.
Also, in this chapter are new four (4) codes Insect bite (nonvenomous) of front wall of thorax:
NEW S20.363 Insect bite (nonvenomous) of bilateral front wall of thorax
NEW S20.364 Insect bite (nonvenomous) of middle front wall of thorax
NEW S20.373 Other superficial bite of bilateral front wall of thorax
NEW S20.374 Other superficial bite of middle front wall of thorax
There are several new codes available for Poisonings by, adverse effect of and underdosing of fentanyl or fentanyl analogs, Poisoning by, adverse effect of and underdosing of tramadol and Poisoning by, adverse effect of and underdosing of other synthetic narcotics.
Finally, in this chapter are twenty (20) new codes for T86.84 Complications of corneal transplant series.
Chapter 20: External causes of morbidity (V00-Y99)
Electric scooters and Segway vehicles have been found to be associated to accidents, in particular with pedestrians. So, this year we have new codes to capture these accident situations. Look in your 2021 codebook at the new codes in the range of V01.0, V01.1, V01.9 for these external cause codes.
Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)
Some new codes to capture Observation for a suspect foreign body ruled out are available:
NEW Z03.82 Encounter for observation for suspected foreign body ruled out
NEW Z03.821 Encounter for observation for suspected ingested foreign body ruled out
NEW Z03.822 Encounter for observation for suspected aspirated (inhaled) foreign body ruled out
NEW Z03.823 Encounter for observation for suspected inserted (injected) foreign body ruled out
Be sure to review the instructional notes as well, i.e., includes and excludes.
The Z68 series of codes for Body Mass Index have a revision of the parenthesis in the BMI codes (BMI) to brackets [BMI] to properly identify the acronym. There are also revisions for “Allergy Status” removing the word “status” at the end of the code description.
Chapter 22: Codes for special purposes (U00-U85)
Notable additions were made mid-year, in April, and finalized with the FY2021 update, with new code U07.0 Vaping-related disorder and U07.1 COVID-19.
The Official Guidelines for Coding and Reporting for FY2021 also have several changes and additions that are extremely noteworthy (i.e., Vaping-related disorder and COVID-19 coding). Be sure to read over the guidelines carefully. Here is the link to the FY2021 guidelines: https://www.cdc.gov/nchs/data/icd/10cmguidelines-FY2021.pdf