Even More Tips to Get ICD-10-CM 2019 Update Prep Rolling (Part 2)

Fri, Jun 15, 2018 --

Coding Updates, ICD-10

ICD-10-CM 2019 updates

Our coverage of ICD-10-CM 2019 updates continues here! In Part 1, you read about diagnosis coding for everything from eyelid disorders to urethral strictures. But there’s more to learn, so let’s keep going!

Keep in mind: Below are just some of the highlights from the new code set, not a complete listing. Plus, the codes we’re discussing here are the preliminary ICD-10-CM 2019 updates from the CDC and CMS. The final list of codes may change before the new code set is implemented for dates of service October 1, 2018, and later.

Focus on These 2 Areas for Ob-Gyn

If you code for multiple-gestation pregnancies, be prepared to choose from new codes that specify that the number of chorions and amnions equal the number of fetuses. One new example is O30.131 (Triplet pregnancy, trichorionic/triamniotic, first trimester).

You’ll also be able to add more detail to your coding for obstetric surgical wound infections (O86.0-), with individual codes for superficial incisional site, deep incisional site, organ and space site, sepsis, other, or unspecified.

Meet New Codes for Maternal Use of Medications

Be sure your documentation is ready to handle new, more specific codes for a newborn affected by maternal medication and drug use. For instance, you’ll want to have the details you need to choose from codes like P04.14 (Newborn affected by maternal use of opiates) and P04.42 (Newborn affected by maternal use of hallucinogens).

Update Your Zika Coding

Zika diagnosis codes were added in a couple of different places in the 2019 ICD-10-CM code set:

  • P35.4 (Congenital Zika virus disease)
  • Z20.821 (Contact with and (suspected) exposure to Zika virus).

Be Ready for Fracture Déjà Vu

If you code fractures, you may recall the 2018 ICD-10-CM revision of a whole bunch of code descriptors to change the term “medial” to “middle.” Well, we’re not done yet!

The 2019 code set continues on the same path by making the same change to more codes. Watch for the changes under S62.62- (Displaced fracture of middle phalanx of finger) and S62.65- (Nondisplaced fracture of middle phalanx of finger).

Don’t Overlook Changes to External-Cause Codes

T codes are part of Chapter 19, Injury, poisoning and certain other consequences of external causes. Here are some areas to note from the T code additions and changes:

  • Watch for options to report ecstasy poisoning under new subcategory T43.64- (Poisoning by ecstasy).
  • Don’t forget about notes with codes! For instance, T74.3 (Psychological abuse, confirmed) has new notes clarifying that the code is appropriate for “Bullying and intimidation, confirmed” and “Intimidation through social media, confirmed.”
  • Check for new code additions specific to confirmed and suspected forced labor and forced sexual exploitation.
  • Remember the obstetric surgical wound infection changes described in the ob-gyn section above? You’ll see similar changes for T81.4- (Infection following a procedure), wanting to know if the surgical site is superficial incisional, deep incisional, organ and space, sepsis, etc.

Add New Z Codes for Exams and Screenings

Among the Z code changes, you’ll find many new encounter codes. In some, you’ll see some similarities to other additions we’ve already discussed, such as exploitation and maternal depression. This isn’t an exhaustive list, but offers an overview of what’s coming:

  • Z04.81 (Encounter for examination and observation of victim following forced sexual exploitation)
  • Z04.82 (Encounter for examination and observation of victim following forced labor exploitation)
  • Z13.31 (Encounter for screening for depression)
  • Z13.32 (Encounter for screening for maternal depression)
  • Z13.41 (Encounter for autism screening)
  • Z13.42 (Encounter for screening for global developmental delays (milestones)).

What About You?

What changes do you think will affect you the most? Did I skip any updates that you think will be important?


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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