ICD 10 CM 2020 Updates Cynthia H Robinson

ICD 10 -CM 2020 Updates Cynthia H. Robinson, CPC. October 17, 2019

2020 Guideline Changes Chapter 21: Factors influencing health status and contact with health services (Z 00 -Z 99) • BMI codes should only be assigned when there is an associated, reportable diagnosis (such as overweight or obesity). Meets the diagnosis of a reportable diagnosis (see section III, reporting Additional Diagnoses). • Do not assign BMI codes during pregnancy. 2

2020 Guideline Changes Chapter 21: Factors influencing health status and contact with health services (Z 00 -Z 99) I. C. 21. c. Counseling (Health Counseling Related to Travel) Ø 10) • Z 71 Persons encountering health services for other counseling and medical advice, not elsewhere classified o Note: Code Z 71. 84, Encounter for health counseling related to travel, is to be used for health risk and safety counseling for future travel purposes. 3

ICD-10 -CM Updates by Chapter Additions Deletions Revisions 2020 Total ICD 10 Codes 273 21 30 72, 184 4

Chapter 1: Certain Infectious and Parasitic Diseases (A 00 – B 99) Coding Note Change (New/Revised Note) Ø A 18. 4 : Tuberculosis of the skin and subcutaneous tissue • Excludes 2: o Lupus erythematosus (L 93. -) o Systemic lupus erythematousus (M 32. -)

Chapter 10: Diseases of the Respiratory System (J 00 -J 99) Coding Note Change: • J 06. 9: Acute upper respiratory infection, unspecified o. Use Additional Code (B 95 -B 97) to identify infectious agent, if known, such as : Respiratory Syncytial Virus (RSV) (B 97. 4) 6

Chapter 14: Diseases of the Genitourinary System Coding Note Change: • N 39. 0 : Urinary tract infection, site not specified o Excludes 1: • • Candidiasis of urinary tract (B 37. 4 -) Neonatal urinary tract infection (P 39. 3) Pyuria (R 82. 81) Urinary tract infection of specified site, such as: o Cystitis (N 30. -) o Urethritis (N 34. -) 7

Chapter 14: Diseases of the Genitourinary System New Codes: Breast Lump in Overlapping Quadrants • N 63. 15: Unspecified lump in the right breast, overlapping quadrants • N 63. 25: Unspecified lump in the left breast, overlapping quadrants v. Use when an unspecified lump in the breast has overlapping anatomical sites that are classifiable to different codes 8

Chapter 14: Diseases of the Genitourinary System New Code: Post Endometrial Ablation Syndrome • N 99. 85: Post endometrial ablation syndrome o Symptoms: ü High degree of pelvic pain ü Cramps ü Pain in legs ü Cramps that compare to labor ü Possible changes in bleeding pattern q Treatment: ü Repeat ablation ü Antibiotics for possible infection ü hysterectomy 9

Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, NEC (R 00 -R 99) New Codes: • R 11. 15 : Cyclical vomiting syndrome unrelated to migraine • R 82. 81 : Pyuria • R 82. 89 : Other abnormal findings on cytological and histological examination of the urine v. Pyuria is a laboratory finding of white blood cells in the urine. v. Most commonly occurs in urinary tract infections. v. Other diseases and conditions can also cause pyuria, such as inflammation, kidney stones, tumor in the urinary tract , certain autoimmune disease, and pneumonia. 10

Chapter 21: Factors influencing health status and contact with health services (Z 00 -Z 99) New Codes: • Z 11. 7 : Encounter for testing for latent tuberculosis infection Status Codes • Z 22. 7 : Latent tuberculosis o Will allow for differentiating patients that have been infected with the Mycobacterium tuberculosis, but do not have active tuberculosis disease. • Z 96. 82: Presence of neurostimulator o Includes the presence of neurostimulators for different sites (brain, gastric, peripheral nerve, sacral nerve, spinal cord, or vagas nerve) 11

Chapter 21: Factors influencing health status and contact with health services (Z 00 -Z 99) Revised Note: • Z 68 : Body mass index (BMI) has revised the age ranges for adult and pediatric BMI codes to resolve an overlap in the age ranges. q. BMI adult codes are for use for persons 20 years of age or older. q. BMI pediatric codes are for use for persons 2 – 19 years of age. 12

Chapter 21: Factors influencing health status and contact with health services (Z 00 -Z 99) New Codes • Z 01. 020 : Encounter for exam of eyes and vision following failed vision screening without abnormal findings • Z 01. 021 : Encounter for exam of eyes and vision following failed vision screening with abnormal findings • Z 71. 84 : Encounter for health counseling related to travel 13

Chapter 21: Factors influencing health status and contact with health services (Z 00 -Z 99) New Codes: Personal History of • Z 86. 002: Personal history of in-situ neoplasm of other and unspecified genital organs • Z 86. 003: Personal history of in-situ neoplasm of oral cavity, esophagus, and stomach • Z 86. 004: Personal history of in-situ neoplasm of other and unspecified digestive organs • Z 86. 005: Personal history of in-situ neoplasm of middle ear and respiratory system • Z 86. 006: Personal history of melanoma in-situ • Z 86. 007: Personal history of in-situ neoplasm of skin • Z 86. 15: Personal history of latent tuberculosis infection 14

Thank you! If you have any questions? ? Please contact Cynthia H. Robinson, CPC. @ Local. Health. Help. Desk@ky. gov Local Health Operations Website: https: //chfs. ky. gov/agencies/dph/dafm/lhob/Pages/default. aspx 15