ICD-10-CM 2018 Posted! Let the Update Games Begin

Fri, Jun 16, 2017 --

Coding Updates, ICD-10

2018 codes are coming

ICD-10-CM 2018 files are up on the CMS site! Here’s a quick overview of what’s coming when the new version goes into effect Oct. 1, 2017. (Looking for PCS? Click here.)

Check Changes by the Numbers

Based on the files posted, it looks like we’ll be dealing with more than 700 updates:

  • 360 additions
  • 142 deletions
  • 226 revisions
  • 71,704 codes total.

Single Our Your Specialty

Here are some changes from the chapters that will see the most updates. Be sure to check the complete files to see the details on the changes that will affect your specialty.

Eye and adnexa: Some of the changes in this section are as simple as a spelling correction (in H02.05-, entropian becomes entropion). But plenty of updates will have a real impact on your coding:

  • H44.2- (Degenerative myopia) will get new options to identify cases with choroidal neovascularization, macular hole, retinal detachment, foveoschisis, and other maculopathy by eye.
  • H54.- (Blindness and low vision) will see a lot of changes to allow you to identify the category for each eye, such as H54.1131 (Blindness right eye category 3, low vision left eye category 1).

Cardiology and vascular: There are four main areas to watch for these updates:

  • Myocardial infarction codes will expand, including a new specific option for type 2 (I21.A1).
  • Pulmonary hypertension options will increase under I27.2- to allow you to better define cause.
  • Heart failure coding options will grow with about 10 new changes, like I50.813 (Acute on chronic right heart failure) and I50.84 (End stage heart failure).
  • Cerebral infarction (I63.-), embolism and thrombosis (I82.81-), and varicose veins (I83.8-) will get some of those tough-to-spot changes, like revising plural terms to singular, so review those with care if you code them.

Gastroenterology: Coding for intestinal adhesions and obstruction will get more specific with about a dozen additions. To code correctly you’ll need to know whether obstructions are partial or complete.

Wound care: If you thought the non-pressure chronic ulcer code list couldn’t get any longer, think again! You’ll get lots of new options to help you report cases without evidence of necrosis.

Ob-gyn: If you code for women’s health, keep an eye on these changes:

  • You’ll be able to specify quadrant when coding for an unspecified lump in the breast under N63.
  • Tubal (O00.1-) and ovarian (O00.2-) pregnancy codes will expand to let you identify the side affected.
  • New subcategory O36.83- will allow you to report maternal care for abnormalities of the fetal heart rate or rhythm, specific to the trimester and fetus involved.
  • Antenatal screening encounter codes (Z36) will get a makeover with 17 new codes so you can identify what the screening is for, such as nuchal translucency (Z36.82) and Strep B (Z36.84).

Neuro: The list of changes for brain conditions is relatively long, but grasping the updates is pretty simple if you know the breakdown.

  • Injury codes of the optic tract (S04.03-) and visual cortex (S04.04-) will change terminology from “eye” to “side”
  • Expect a mass deletion of subsequent and sequela codes from S06.- that have the phrase “loss of consciousness of any duration with death.” (It makes sense when you think about it.)

Orthopedics: A few minor changes will lead to a whole lot of updates:

  • Code descriptors for metacarpal fracture (S62.3-) have a period in the middle in 2017, so the 2018 version changes that to a comma.
  • Phalanx fracture codes for the finger (S26.6-) and toe (S92.5-) will see a language swap from “medial phalanx” to “middle phalanx.”
  • Subluxation and dislocation codes (S63.12-) for thumb interphalangeal joints will get cleaned up to remove references to proximal and distal.

What About You?

How do you prep for ICD-10-CM updates? Tip: You can get automatic updates by signing up for ICD-10-CM Code Lookup FREE for a year!


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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1 Comments For This Post

  1. sarav Says:

    Very very useful-Thanks

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