ICD-10-CM 2019: Here’s What You Need to Know About Appendicitis, Screenings, and Blepharitis

ICD-10-CM 2019 implementation is just a couple of months away. The effective date, Oct. 1, 2018, is coming our way fast. Here are some interesting tidbits from our TCI Coding Alerts on the 2019 diagnosis code updates for appendicitis, screenings, and eye care to help you prepare.

Bonus tip: The 2019 ICD-10-CM Official Guidelines for Coding and Reporting are now available on the CDC site. Updates include the new rule allowing you to report social determinants from Z55-Z65 based on documentation from all clinicians involved in patient care. (See our last post for more information on that change.)

Train for More Specific Appendicitis Codes

New K35.- codes will add specificity to appendicitis codes based on the presence of abscess, perforation, and gangrene. The key terms in the 2018 codes, localized peritonitis and generalized peritonitis, are still present in the new options, too. One example of the many possible variations is K35.33 (Acute appendicitis with perforation and localized peritonitis, with abscess).

Tip: Notify documenting providers about this new level of specificity for abscess, perforation, and gangrene so that when they have that information available, they are sure to document it, advises an article in Emergency Department Coding & Reimbursement Alert. Clinicians may not be including that specific information now.

Move Away From ‘NOS’ Code for Many Screenings

ICD-10-CM 2019 adds a lot of new options for screenings, such as K13.31 (Encounter for screening for depression) and Z13.41 (Encounter for autism screening).

These more specific code options may help improve reimbursement speed because the payer can see the nature of the screening from the claim rather than having to request medical records, according to an update in Primary Care Coding Alert.

Don’t miss: Not every common screening type got a new, more specific code. For instance, for alcoholism screening and intellectual disability screening, you’ll use new “other” code Z13.39 (Encounter for screening examination for other mental health and behavioral disorders).

Be on the Lookout for Combo Eye Codes

A noteworthy number of the ICD-10-CM 2019 changes add specificity to eyelid conditions. For the most part, if you have documentation of right eye/left eye and upper lid/lower lid, you’ll have what you need to choose from the new, more specific codes.

But, from the coding side, you also need to know when to choose a code that combines two locations, according to a recent posting from Ophthalmology and Optometry Coding Alert. Specifically, eye care coders will have new blepharitis options that cover both upper and lower lids in a single code. Here are some examples:

  • H01.00A (Unspecified blepharitis right eye, upper and lower eyelids)
  • H01.01B (Ulcerative blepharitis left eye, upper and lower eyelids)
  • H01.02A (Squamous blepharitis right eye, upper and lower eyelids).

What About You?

Are you planning to do any documentation and coding training for the new 2019 ICD-10-CM codes, or have you already gotten started? What do you think are the most important points to cover in ICD-10-CM 2019 training?



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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