The 2020 annual update to the ICD-10-CM[i] system used in medical insurance claim billing became effective on October 1, 2019. Twenty-one (21) codes were deleted, thirty (30) codes were revised and 273 new codes were added. The good news for radiologists is that relatively few of these changes will affect your work.
The guidelines for use of the system include a general warning not to use terms that convey uncertainty, such as “probable”, “suspected”, “questionable”, “rule out”, or “working diagnosis”. To this list have been added the terms “compatible with” and “consistent with”.
The codes that have been deleted fall into the following categories:
- Vertigo
- Atrial fibrillation
- Congenital conditions
- Ehlers-Danlos syndrome
- ADA deficiency
- Heatstroke or sunstroke
If a patient exam is presented with the need to use a diagnosis code in one of these areas, further investigation into the coding should be made. Otherwise, you do not need to worry about using outdated codes.
New codes have been added for reporting in the Genitourinary System:
| Unspecified lump in the breast, overlapping quadrants | |
| Right breast | N63.15 |
| Left breast | N63.25 |
| Post endometrial ablation syndrome | N99.85 |
New codes have been added for reporting in the Circulatory System:
| Phlebitis and thrombophlebitis of the: | |
| Right peroneal vein | 180.241 |
| Left peroneal vein | 180.242 |
| Peroneal vein, bilateral | 180.243 |
| Unspecified peroneal vein | 180.249 |
| Right calf muscular vein | 180.251 |
| Left calf muscular vein | 180.252 |
| Calf muscular vein, bilateral | 180.253 |
| Unspecified calf muscular vein | 180.259 |
| Acute embolism and thrombosis of the: | |
| Right peroneal vein | 182.451 |
|
Left peroneal vein |
182.452 |
| Peroneal vein, bilateral | 182.453 |
| Unspecified peroneal vein | 182.459 |
| Right calf muscular vein | 182.461 |
| Left calf muscular vein | 182.462 |
| Calf muscular vein, bilateral | 182.463 |
| Unspecified calf muscular vein | 182.469 |
Twenty-five (25) codes were added to describe various fractures of the orbit or orbital roof:
| Fracture of orbital roof, | left side | right side | unspecified side |
| Initial encounter for closed fracture | S02.122A | S02.121A | S02.129A |
| Initial encounter for open fracture | S02.122B | S02.121B | S02.129B |
| Subsequent encounter for routine healing | S02.122D | S02.121D | S02.129D |
| Subsequent encounter for fracture with delayed healing | S02.122G | S02.121G | S02.129G |
| Subsequent encounter for fracture with nonunion | S02.122K | S02.121K | S02.129K |
| Sequela | S02.122S | S02.121S | S02.129S |
| Fracture of orbit, unspecified side | |
| Initial encounter for closed fracture | S02.85XA |
| Initial encounter for open fracture | S02.85XB |
| Subsequent encounter for routine healing | S02.85XD |
|
Subsequent encounter for fracture with delayed healing |
S02.85XG |
| Subsequent encounter for fracture with nonunion | S02.85XK |
| Sequela | S02.85XS |
| Fracture of lateral orbital wall, unspecified side, sequela | S02.849S |
Finally, seven (7) codes were added to describe the types of Ehlers-Danlos syndrome and other congenital conditions to replace some of the deleted codes.
Generally, of greater impact than the ICD coding changes is the annual revision of the Current Procedural Terminology (CPT) system that takes effect at the beginning of each year. Watch for our full coverage of the important coding changes for radiology. Subscribe to this blog to keep abreast of these issues and other news that affects your practice.
[i] ICD stands for International Classification of Diseases, the system owned and copyrighted by the World Health Organization that is used to report diagnoses when submitting claims for reimbursement of physician services, among many other purposes. ICD-10 is the 10th edition of this coding system. CM stands for the Clinical Modification of the classification system.
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