PCC CODING WEBLAB. Effective 10/1/18. ICD Code Manuals. September 2018 Agenda. CMS provides this zip file containing FREE PDFs of the ICD code manuals
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1 PCC CODING WEBLAB Jan Blanchard, CPMA Tuesday, Sept 18, 2018 Noon, Eastern September 2018 Agenda 2019 ICD-10 code updates Effective 10/1/18 ICD Code Manuals CMS provides this zip file containing FREE PDFs of the ICD code manuals 2019 Code Descriptions in Tabular Order [ZIP, 2MB] 2019 Code Tables and Index [ZIP, 18MB] 2019 Addendum [ZIP, 685KB] 2019 Conversion Table [ZIP, 73KB] 2019 Coding Guidelines [PDF, 604KB] 2019 POA Exempt Codes [ZIP, 1MB]
2 File Names snomedmap snomedmap
3 Legend BOLD = New additions STRIKETHROUGH = deleted selections ITALICS = Nuances, differences New Additions E78.41 Elevated Lipoprotein(a) E78.49 Other hyperlipidemia F12.23 Cannabis dependence with withdrawal Cannabis withdrawal - removed from F F12.93 Cannabis use, unspecified with withdrawal F53.0 Postpartum depression Postnatal depression, NOS Postpartum depression, NOS F53.1 Puerperal psychosis Postpartum psychosis Puerperal psychosis, NOS New Additions H01.00 Unspecified blepharitis H01.00A Unspecified blepharitis right eye, upper and lower eyelids H01.00B Unspecified blepharitis left eye, upper and lower eyelids H01.01 Ulcerative blepharitis H01.01A Ulcerative blepharitis right eye, upper and lower eyelids H01.01B Ulcerative blepharitis left eye, upper and lower eyelids
4 New Additions Appendicitis - K35.2_ Appendicitis - K35.3_ H10.82 Rosacea conjunctivitis Code first underlying rosacea dermatitis (L71.-) H Rosacea conjunctivitis, right eye H Rosacea conjunctivitis, left eye H Rosacea conjunctivitis, bilateral H Rosacea conjunctivitis, unspecified eye K35 Acute appendicitis K35.2 Acute appendicitis with generalized peritonitis Perforated appendix NOS Ruptured appendix NOS K35.20 Acute appendicitis with generalized peritonitis, without abscess (Acute) appendicitis with generalized peritonitis NOS K35.21 Acute appendicitis with generalized peritonitis, with abscess THESE K35.3 Acute appendicitis with localized peritonitis Acute appendicitis with or without perforation or rupture with peritonitis NOS Acute appendicitis with or without perforation or rupture with localized peritonitis Acute appendicitis with peritoneal abscess
5 Appendicitis - K35.3_ BECAME THIS... K35.30 Acute appendicitis with localized peritonitis, without perforation or gangrene Acute appendicitis with localized peritonitis NOS K35.31 Acute appendicitis with localized peritonitis and gangrene, without perforation K35.32 Acute appendicitis with perforation and localized peritonitis, without abscess (Acute) appendicitis with perforation NOS Perforated appendix NOS Ruptured appendix (with localized peritonitis) NOS K35.33 Acute appendicitis with perforation and localized peritonitis, with abscess (Acute) appendicitis with (peritoneal) abscess NOS Ruptured appendix with localized peritonitis and abscess Appendicitis K35.8 Other and unspecified acute appendicitis K35.89 Other acute appendicitis K Other acute appendicitis without perforation or gangrene K Other acute appendicitis without perforation, with gangrene (Acute) appendicitis with gangrene NOS K37 Unspecified appendicitis Excludes1: -unspecified appendicitis with peritonitis (K35.2-K35.3) -unspecified appendicitis with peritonitis (K35.2-, K35.3-) Myalgia M79.1 Myalgia M79.10 Myalgia, unspecified site M79.11 Myalgia of mastication muscle M79.12 Myalgia of auxiliary muscles, head and neck M79.18 Myalgia, other site
6 There ARE Changes to O chapter Do NOT use letter O codes for newborn or pediatric conditions Newborn affected by... P02 Newborn affected by complications of placenta, cord and membranes P02.7 Newborn affected by chorioamnionitis Newborn affected by amnionitis Newborn affected by membranitis Newborn affected by placentitis P02.70 Newborn affected by fetal inflammatory response syndrome Newborn affected by FIRS P02.78 Newborn affected by other conditions from chorioamnionitis Newborn affected by amnionitis Newborn affected by membranitis Newborn affected by placentitis Newborn affected by... P04 Newborn affected by noxious substances transmitted via placenta or breast milk P04.0 Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery Newborn affected by reactions and intoxications from maternal opiates and tranquilizers administered during labor and delivery Newborn affected by reactions and intoxications from maternal opiates and tranquilizers administered for procedures during pregnancy or labor and delivery Excludes2: newborn affected by other maternal medication (P04.1-)
7 Newborn affected by... Newborn affected by maternal... Newborn affected by... P04.1 Newborn affected by other maternal medication Newborn affected by cancer chemotherapy Newborn affected by cytotoxic drugs Code first withdrawal symptoms from maternal use of drugs of addiction, if applicable (P96.1) Excludes1: maternal use of drugs of addiction (P04.4-) Excludes2: maternal anesthesia and analgesia in pregnancy, labor and delivery (P04.0) maternal use of drugs of addiction (P04.4-) P04.11 antineoplastic chemotherapy P cytotoxic drugs P use of anticonvulsants P use of opiates P04.15 use of antidepressants P use of amphetamines P use of sedative-hypnotics P04.1A use of anxiolytics P04.18 other maternal medication P04.19 use of unspecified medication P04.4 Newborn affected by maternal use of drugs of addiction P04.40 Newborn affected by maternal use of unspecified drugs of addiction P04.42 Newborn affected by maternal use of hallucinogens Excludes2: newborn affected by other maternal medication (P04.1-) P04.8 Newborn affected by other maternal noxious substances P04.81 Newborn affected by maternal use of cannabis P04.89 Newborn affected by other maternal noxious substances
8 Zika Virus Punctuation Fixes Abnormal Urine P35 Congenital viral diseases P35.4 Congenital Zika virus disease Q02 Microcephaly Use Additional code, if applicable, to identify congenital Zika virus disease Z Contact with and (suspected) exposure to Zika virus Removed a stray : P83.81 Umbilical granuloma Excludes2: : Granulomatous disorder of the skin and subcutaneous tissue, unspecified (L92.9) Granulomatous disorder of the skin and subcutaneous tissue, unspecified (L92.9) Removed a stray space Q67.5 Congenital deformity of spine Excludes1: infantile idiopathic scoliosis (M41.0 ) infantile idiopathic scoliosis (M41.0) THESE R82.99 Other abnormal findings in urine Cells and casts in urine Crystalluria Melanuria
9 Abnormal Urine BECAME THIS R Hypocitraturia R Hyperoxaluria Excludes1: Primary hyperoxaluria (E72.53) R Hyperuricoscuria R Hypercalciuria Idiopathic hypercalciuria R Other abnormal findings in urine Cells and casts in urine Crystalluria Melanuria Poisoning by Ecstasy T43.64 Poisoning by ecstasy Poisoning by MDMA Poisoning by 3,4-methylenedioxymethamphetamine T Poisoning by ecstasy, accidental (unintentional) Poisoning by ecstasy NOS T Poisoning by ecstasy, intentional self-harm T Poisoning by ecstasy, assault T Poisoning by ecstasy, undetermined Exploitation and Abuse - Confirmed T74.3 Psychological abuse, confirmed Bullying and intimidation, confirmed Intimidation through social media, confirmed T74.5 Forced sexual exploitation, confirmed T74.51 Adult forced sexual exploitation, confirmed T74.52 Child sexual exploitation, confirmed T74.6 Forced labor exploitation, confirmed T74.61 Adult forced labor exploitation, confirmed T74.62 Child forced labor exploitation, confirmed T76 Adult and child abuse, neglect and other maltreatment, suspected
10 Exploitation and Abuse - Suspected T76.3 Psychological abuse, suspected Bullying and intimidation, suspected Intimidation through social media, suspected T76.5 Forced sexual exploitation, suspected T76.51 Adult forced sexual exploitation, suspected T76.52 Child sexual exploitation, suspected T76.6 Forced labor exploitation, suspected T76.61 Adult forced labor exploitation, suspected T76.62 Child forced labor exploitation, suspected Exam & Observation Z04 Encounter for examination and observation for other reasons 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 Digit to Character V01-V09 with 5th digit 9 Became: V01-V09 with 5th character 9
11 Weather Events Weather Events Z00.12 Changes X37 Cataclysmic storm X37.9 Unspecified cataclysmic storm Excludes1: collapse of dam or man-made structure causing earth movement (X39.0) collapse of dam or man-made structure causing earth movement (X36.0) X38 Flood Excludes1: collapse of dam or man-made structure causing earth movement (X39.0) collapse of dam or man-made structure causing earth movement (X36.0) tidal wave caused by storm (X37.2) tidal wave caused by storm (X37.42) X39 Exposure to other forces of nature X39.0 Exposure to natural radiation Excludes1: contact with and (suspected) exposure to radon and other naturally occuring radiation (Z77.123) contact with and (suspected) exposure to radon and other naturally occurring radiation (Z77.123) Z00.12 Encounter for routine child health examination Encounter for development testing of infant or child Immunizations appropriate for age Routine developmental screening of infant or child Routine vision and hearing testing
12 Mental Health Screening Mental Health Screening Developmental screening Z13.3 Encounter for screening examination for mental health and behavioral disorders Z13.30 Encounter for screening examination for mental health and behavioral disorders, unspecified Z13.31 Encounter for screening for depression Encounter for screening for depression, adult Encounter for screening for depression for child or adolescent Z13.32 Encounter for screening for maternal depression Encounter for screening for perinatal depression Z13.39 Encounter for screening examination for other mental health and behavioral disorders Encounter for screening for alcoholism Encounter for screening for intellectual disabilities Z13.4 Encounter for screening for certain developmental disorders in childhood Encounter for development testing of infant or child Excludes1: routine development testing of infant or child (Z00.1-) Excludes2: encounter for routine child health examination (Z00.12-) Z13.40 Encounter for screening for unspecified developmental delays Z13.41 Encounter for autism screening Z13.42 Encounter for screening for global developmental delays (milestones) Encounter for screening for developmental handicaps in early childhood Z13.49 Encounter for screening for other developmental delays
13 Unavailability of Vaccine Z28.83 Immunization not carried out due to unavailability of vaccine Delay in delivery of vaccine Lack of availability of vaccine Manufacturer delay of vaccine History Additions Z Personal history of forced labor or sexual exploitation in childhood Z83.43 Family history of other disorder of lipoprotein metabolism and other lipidemias Z Family history of elevated lipoprotein(a) Family history of elevated Lp(a) Z Family history of other disorder of lipoprotein metabolism and other lipidemia Z91.42 Personal history of forced labor or sexual exploitation Language Corrections Finger Fractures: medial to middle Babystroller to Baby stroller Motorscooter to Motor scooter Snow boarding to Snowboarding Naturally occuring to Naturally occurring Defribillator to defibrillator
14 Language Changes External Cause Addenda Coming Attractions H Unspecified epiphora, right lacrimal gland >>H Unspecified epiphora, right side H Unspecified epiphora, left lacrimal gland >>H Unspecified epiphora, left side H Unspecified epiphora, bilateral lacrimal glands >>H Unspecified epiphora, bilateral H Unspecified epiphora, unspecified lacrimal gland >>H Unspecified epiphora, unspecified side V8.6 Beta Deployment: Mid October, 2018 V.6 General Deployment: Sunday, November 4, 2018
15 Roadmap - Version 8.6 *PROPOSED* EHR Highlights: ICD-10s in Flowsheet Mandated code set updates: a. LOINC b. VIS c. NDC d. RVU Verify Eligibility Custom Report Categories Roadmap - Version 8.6 *PROPOSED* EHR Highlights: New Reports a. Obesity follow-up b. Predominant conditions & health concerns New Dashboard Measure "Immunizations for Adolescents" (TdaP/Meningococcal/HPV) Resources AAP's Private Payer Advocacy Templates for Appeal Letters
16 Next Coding Weblab: Wed, Oct 17, pm Eastern What Questions Do You Have? How do I code for? What do I do when carriers deny because? How can I find a code for? Shouldn t my payers process? Jan Blanchard, CPC, CPMA Pediatric Solutions Consultant PCC Control Your Future. jan@pcc.com
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