Breaking News: Get an ICD-10-CM 2019 Overview (Part 1)

Wed, Jun 13, 2018 --

Coding Updates, ICD-10

ICD-10-CM 2019 updates

The preliminary ICD-10-CM 2019 code list shows roughly 280 new reportable codes and about 170 revisions. As you check into the 2019 diagnosis code changes, here are some trends and highlights to be alert for. (Watch for more coverage of the 2019 ICD-10-CM updates in the next post.)

Remember: This is a preliminary list. The final list may change before you start using the 2019 codes for dates of service Oct. 1, 2018, and later. You can check out the complete early list of 2019 updates on the CMS and CDC sites, and lists of changes will be available to subscribers on the TCI SuperCoder site soon!

Add Upper/Lower Specificity for Eyelids

If you report eyelid neoplasms and disorders, make sure your documentation always records whether the upper or lower eyelid is involved. The 2019 code set adds that upper/lower distinction to a number of diagnoses, with new codes like these:

  • C44.1192 (Basal cell carcinoma of skin of left lower eyelid, including canthus)
  • D23.111 (Other benign neoplasm of skin of right upper eyelid, including canthus)
  • H02.152 (Paralytic ectropion of right lower eyelid).

Choose Unique Code for Postpartum Depression

In the 2018 code set, you use F53 (Puerperal psychosis) for postpartum depression. The 2019 code set changes this by revising the descriptor for F53 and changing it to a parent code. Here’s how the new options will appear:

  • F53 (Mental and behavioral disorders associated with the puerperium, not elsewhere classified)
    • F53.0 (Postpartum depression)
      • Postnatal depression, NOS
      • Postpartum depression, NOS
    • F53.1 (Puerperal psychosis)
      • Postpartum psychosis
      • Puerperal psychosis, NOS.

Extend G71.0 to Report Muscular Dystrophy Type

Instead of reporting four-character code G71.0 (Muscular dystrophy), expect to report one of these more specific codes in 2019:

  • G71.00 (Muscular dystrophy unspecified)
  • G71.01 (Duchenne or Becker muscular dystrophy)
  • G71.02 (Facioscapulohumeral muscular dystrophy)
  • G71.09 (Other specified muscular dystrophies).

Act on These Acute Appendicitis Changes

To handle more specific ICD-10-CM codes for acute appendicitis, be sure your documentation specifies the presence of any abscess, perforation or gangrene. Then you’ll be able to choose from nearly 10 new codes, like K35.30 (Acute appendicitis with localized peritonitis, without perforation or gangrene).

Know the Site of Male Urethral Stricture

Even if you’re reporting an “other” (N35.81-) or “unspecified” (N35.91-) code for a male urethral stricture, ICD-10-CM 2019 will allow you to report the site: meatal, bulbous, membranous, anterior, or overlapping sites. You’ll have an “unspecified site” option, too.

Remember, Changes May Be Corrections

Many of the revisions correct simple typos, so you’re sure to come across at least one revision where you have a hard time determining what the difference is between the 2018 and 2019 content. For instance, check out this Excludes1 note for B51 (Plasmodium vivax malaria):

  • 2018: plasmodium vivav with Plasmodium falciparum (B50.-)
  • 2019: plasmodium vivax with Plasmodium falciparum (B50.-).

Did you catch the difference? The correction revises vivav to vivax, which can be tough to spot.

What About You?

Have you checked out the 2019 ICD-10-CM code set yet? What do you think?

 

 

 

 

 

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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