2019 ICD-10-CM Code Changes

The ICD-10-CM code set in the United States is maintained by the ICD-10 Coordination and Maintenance Committee. This committee reviews all requests for changes or additions to the code set and includes representatives from the National Center for Health Statistics (NCHS) and the Centers for Medicare and Medicaid Services (CMS).

ACOG’s Committee on Health Economics and Coding meets regularly with members of the ICD-10 Committee to discuss requests (from ACOG, other groups, or from individuals) for changes in current ob-gyn-related codes or for the creation of new codes. ACOG’s Committee also answers questions from the ICD-10 Committee concerning appropriate terminology and definitions for ob-gyn diagnoses.

The Director of NCHS and the Administrator of CMS make the final coding data set decisions. Changes become effective October 1 of each year, with no grace period provided for implementation. 

HIPAA requires insurers to accept new diagnosis codes beginning October 1st. 

The International Classification of Diseases, 10th Edition, Clinical Modification, (ICD-10-CM) code set for 2019 includes quite a few updates of interest to ob-gyns. 

The ICD-10 Coordination and Maintenance Committee approved the following changes for 2019.  These code changes are valid for coding for dates of service 10/1/2018 – 9/30/2019. 

Notes:

  • Codes marked as “DELETED” should NOT be used after 9/30/2018.
  • “-“ indicates additional characters are required for correct code selection.

Code subcategory E78.4 has been expanded to identify specific lipid conditions.

DELETED CODE

 

 

                NEW CODES

E78.4

Other hyperlipidemia             

E78.41

Elevated lipoprotein(a)

E78.49

Other hyperlipidemia

Code subcategory E88.0- has a new code for plasminogen deficiency.

NEW CODE

E88.02

Plasminogen deficiency

Code category F12 has two new codes for identifying withdrawal associated with cannabis use.

NEW CODES

F12.23

Cannabis dependence with withdrawal

F12.93

Cannabis use, unspecified with withdrawal

Code category F53 has been revised to include a new postpartum depression code.

                  DELETED CODE

 

      

                       NEW CODES

F53

Puerperal psychosis

              F53.0

Postpartum depression

              F53.1

Puerperal psychosis

New codes for female urethral stricture have been added to code category N35.

       DELETED CODES

 

NEW CODES

N35.8

Other urethral stricture

N35.82

Other urethral stricture, female

N35.9

Urethral stricture, unspecified

N35.92

Unspecified urethral stricture, female

Code category O30 has been modified to provide additional specificity for chorions and amnions in multiple gestation.

NEW CODES

O30.131

Triplet pregnancy, trichorionic/triamniotic, first trimester

O30.132

Triplet pregnancy, trichorionic/triamniotic, second trimester

O30.133

Triplet pregnancy, trichorionic/triamniotic, third trimester

O30.139

Triplet pregnancy, trichorionic/triamniotic, unspecified trimester

O30.231

Quadruplet pregnancy, quadrachorionic/quadra-amniotic, first trimester

O30.232

Quadruplet pregnancy, quadrachorionic/quadra-amniotic, second trimester

O30.233

Quadruplet pregnancy, quadrachorionic/quadra-amniotic, third trimester

O30.239

Quadruplet pregnancy, quadrachorionic/quadra-amniotic, unspecified trimester

O30.831

Other specified multiple gestation, number of chorions and amnions are both equal to the number of fetuses, first trimester

O30.832

Other specified multiple gestation, number of chorions and amnions are both equal to the number of fetuses, second trimester

O30.833

Other specified multiple gestation, number of chorions and amnions are both equal to the number of fetuses, third trimester

O30.839

Other specified multiple gestation, number of chorions and amnions are both equal to the number of fetuses, unspecified trimester

Code subcategory O86.0 has been expanded to further specify obstetrical wound infections.

DELETED CODES

 

NEW CODES

O86.0

Infection of obstetric surgical

wound

O86.00

Infection of obstetric surgical wound, unspecified

O86.01

Infection of obstetric surgical wound, superficial incisional site

O86.02

Infection of obstetric surgical wound, deep incisional site

O86.03

Infection of obstetric surgical wound, organ and space site

O86.04

Sepsis following an obstetrical procedure

O86.09

Infection of obstetric surgical wound, other surgical site

Code subcategory Q51.2 has been revised to include new codes for other doubling of the uterus.

DELETED CODE

 

NEW CODES

Q51.2

Other doubling of uterus

Q51.20

Other doubling of uterus, unspecified

Q51.21

Other complete doubling of uterus

Q51.22

Other partial doubling of uterus

Q51.28

Other doubling of uterus, other specified

Specific codes for abnormal urine findings have been added to code subsection R82.99.

DELETED CODE

 

NEW CODES

R82.99

Other abnormal findings in urine

R82.991

Hypocitraturia

R82.992

Hyperoxaluria

R82.993

Hyperuricoscuria

R82.994

Hypercalciuria

R82.998

Other abnormal findings in urine

Code subcategory R93.8 has been expanded to identify other abnormal findings on diagnostic imaging.

DELETED CODE

 

NEW CODES

R93.8

Abnormal findings on diagnostic imaging of other specified body structures

R93.89

Abnormal findings on diagnostic imaging of other specified body structures

Poisoning by ecstasy (previously coded to T43.62-) now has its own distinct code subsection.

NEW CODES

T43.641A

Poisoning by ecstasy, accidental (unintentional), initial encounter

T43.641D

Poisoning by ecstasy, accidental (unintentional), subsequent encounter

T43.641S

Poisoning by ecstasy, accidental (unintentional), sequela

T43.642A

Poisoning by ecstasy, intentional self-harm, initial encounter

T43.642D

Poisoning by ecstasy, intentional self-harm, subsequent encounter

T43.642S

Poisoning by ecstasy, intentional self-harm, sequela

T43.643A

Poisoning by ecstasy, assault, initial encounter

T43.643D

Poisoning by ecstasy, assault, subsequent encounter

T43.643S

Poisoning by ecstasy, assault, sequela

T43.644A

Poisoning by ecstasy, undetermined, initial encounter

T43.644D

Poisoning by ecstasy, undetermined, subsequent encounter

T43.644S

Poisoning by ecstasy, undetermined, sequela

New codes for adult forced exploitation have been added to code categories T74 (confirmed cases) and T76 (suspected cases).

NEW CODES

T74.51XA

Adult forced sexual exploitation, confirmed, initial encounter

T74.51XD

Adult forced sexual exploitation, confirmed, subsequent encounter

T74.51XS

Adult forced sexual exploitation, confirmed, sequela

T74.61XA

Adult forced labor exploitation, confirmed, initial encounter

T74.61XD

Adult forced labor exploitation, confirmed, subsequent encounter

T74.61XS

Adult forced labor exploitation, confirmed, sequela

T76.51XA

Adult forced sexual exploitation, suspected, initial encounter

T76.51XD

Adult forced sexual exploitation, suspected, subsequent encounter

T76.51XS

Adult forced sexual exploitation, suspected, sequela

T76.61XA

Adult forced labor exploitation, suspected, initial encounter

T76.61XD

Adult forced labor exploitation, suspected, subsequent encounter

T76.61XS

Adult forced labor exploitation, suspected, sequela

Code subcategory T81.4 has been modified to further categorize reporting of postoperative infections.

NEW CODES

T81.40XA

Infection following a procedure, unspecified, initial encounter

T81.40XD

Infection following a procedure, unspecified, subsequent encounter

T81.40XS

Infection following a procedure, unspecified, sequela

T81.41XA

Infection following a procedure, superficial incisional surgical site, initial encounter

T81.41XD

Infection following a procedure, superficial incisional surgical site, subsequent encounter

T81.41XS

Infection following a procedure, superficial incisional surgical site, sequela

T81.42XA

Infection following a procedure, deep incisional surgical site, initial encounter

T81.42XD

Infection following a procedure, deep incisional surgical site, subsequent encounter

T81.42XS

Infection following a procedure, deep incisional surgical site, sequela

T81.43XA

Infection following a procedure, organ and space surgical site, initial encounter

T81.43XD

Infection following a procedure, organ and space surgical site, subsequent encounter

T81.43XS

Infection following a procedure, organ and space surgical site, sequela

T81.44XA

Sepsis following a procedure, initial encounter

T81.44XD

Sepsis following a procedure, subsequent encounter

T81.44XS

Sepsis following a procedure, sequela

T81.49XA

Infection following a procedure, other surgical site, initial encounter

T81.49XD

Infection following a procedure, other surgical site, subsequent encounter

T81.49XS

Infection following a procedure, other surgical site, sequela

Code subcategory Z04.8 has been revised to include new codes for exam and observation due to exploitation.

DELETED CODE

 

NEW CODES

Z04.8

Encounter for examination and observation for other specified reasons

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

Z04.89

Encounter for examination and observation for other specified reasons

New code subcategory Z13.3- has been added to identify screening for depression and other mental disorders.

NEW CODES

Z13.30

Encounter for screening examination for mental health and behavioral disorders, unspecified

Z13.31

Encounter for screening for depression

Z13.32

Encounter for screening for maternal depression

Z13.39

Encounter for screening examination for other mental health and behavioral disorders

Contact with the Zika virus now has its own unique code.

NEW CODE

Z20.821

Contact with and (suspected) exposure to Zika virus

A new code has been added to code category Z28 to indicate why immunization was not performed.

NEW CODE

Z28.83

Immunization not carried out due to unavailability of vaccine

New codes for personal history of exploitation are now included in the code set.

NEW CODES

Z62.813

Personal history of forced labor or sexual exploitation in childhood

Z91.42

Personal history of forced labor or sexual exploitation

Code subcategory Z83.4- has been expanded to further specify family history of lipid disorders.

NEW CODES

Z83.430

Family history of elevated lipoprotein(a)

Z83.438

Family history of other disorder of lipoprotein metabolism and other lipidemia

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