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Use 2020 ICD-10-CM Codes for More Specific Medical Data Capture

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  • September 9, 2019
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Use 2020 ICD-10-CM Codes for More Specific Medical Data Capture

In a world of uncertainty, one thing medical coders can count on is ICD-10-CM yearly updates.

It’s already that time of year again when the Centers for Disease Control and Prevention (CDC) releases the ICD-10-CM code update for next year. Familiarizing yourself with the changes that go into effect Oct. 1 will help you capture the proper and most specific diagnosis codes for patients’ conditions.
There are currently 71,932 ICD-10-CM codes, but next month we’ll have 72,184, which includes 273 additions, 21 deletions, and 30 revisions. Many of the deletions made were to allow for more specific codes to be added. Review the changes, additions, and deletions:

Revised Deleted Added
B96.21– B96.23:
The parentheses are changed to brackets.
D75.A Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
D81.3 D81.30 Adenosine deaminase deficiency, unspecified
D81.31 Severe combined immunodeficiency due to adenosine deaminase deficiency
D81.32 Adenosine deaminase 2 deficiency
D81.39 Other adenosine deaminase deficiency
“In migraine” verbiage is added 
H81.41 Vertigo of central origin, right ear
H81.42 Vertigo of central origin, left ear
H81.43 Vertigo of central origin, bilateral
H81.49 Vertigo of central origin, unspecified ear
H81.4 Vertigo of central origin
I26.93 Single subsegmental pulmonary embolism without acute cor pulmonale
I26.94 Multiple subsegmental pulmonary emboli with acute cor pulmonale
I48.1 I48.11 Longstanding persistent atrial fibrillation
I48.19 Other persistent atrial fibrillation
I48.2 I48.20 Chronic atrial fibrillation, unspecified
I48.21 Permanent atrial fibrillation
“Right” is removed due to redundancy.I70.248:
“Left” is removed due to redundancy
I80.241 – I80.249: Phlebitis and thrombophlebitis of peroneal vein
I80.251 – I80.259: Phlebitis and thrombophlebitis of calf muscular vein
I82.451 – I82.459: Acute embolism and thrombosis peroneal vein
I82.461 – I82.469: Acute embolism and thrombosis calf muscular vein
I82.551 – I82.559: Chronic embolism and thrombosis of peroneal vein
I82.561 – I82.569: Chronic embolism and thrombosis calf muscular vein
Parentheses is added to the word “acute.”
L89.006 – L89.96: Pressure-induced deep tissue damage of elbow, back, buttock, hip, ankle, heel, other site, or unspecified site
Check the individual codes for their various verbiage revisions.
N63.15 Unspecified lump in the right breast, overlapping quadrants
N63.25 Unspecified lump in the left breast, overlapping quadrants
N99.85 Post endometrial ablation syndrome
Q66.00 Q66.00 Congenital talipes equinovarus, unspecified foot
Q66.01 Congenital talipes equinovarus, right foot
Q66.02 Congenital talipes equinovarus, left foot
Q66.1 Q66.10 Congenital talipes calcaneovarus, unspecified foot
Q66.11 Congenital talipes calcaneovarus, right foot
Q66.12 Congenital talipes calcaneovarus, left foot
Q66.21 Q66.211 Congenital metatarsus primus varus, right foot
Q66.212 Congenital metatarsus primus varus, left foot
Q66.219 Congenital metatarsus primus varus, unspecified foot
Q66.22 Q66.221 Congenital metatarsus adductus, right foot
Q66.222 Congenital metatarsus adductus, left foot
Q66.229 Congenital metatarsus adductus, unspecified foot
Q66.3 Q66.30 Other congenital varus deformities of feet, unspecified foot
Q66.31 Other congenital varus deformities of feet, right foot
Q66.32 Other congenital varus deformities of feet, left foot
Q66.4 Q66.40 Congenital talipes calcaneovalgus, unspecified foot
Q66.41 Congenital talipes calcaneovalgus, right foot
Q66.42 Congenital talipes calcaneovalgus, left foot
Q66.7 Q66.70 Congenital pes cavus, unspecified foot
Q66.71 Congenital pes cavus, right foot
Q66.72 Congenital pes cavus, left foot
Q66.9 Q66.90 Congenital deformity of feet, unspecified, unspecified foot
Q66.91 Congenital deformity of feet, unspecified, right foot
Q66.92 Congenital deformity of feet, unspecified, left foot
Q79.6 Q79.60 Ehlers-Danlos syndrome, unspecified
Q79.61 Classical Ehlers-Danlos syndrome
Q79.62 Hypermobile Ehlers-Danlos syndrome
Q79.63 Vascular Ehlers-Danlos syndrome
Q79.69 Other Ehlers-Danlos syndromes
Q87.1 Q87.11 Prader-Willi syndrome
Q87.19 Other congenital malformation syndromes predominately associated with short stature
R11.15 Cyclical vomiting syndrome unrelated to migraine
R82.8 R82.81 Pyuria
R82.89 Other abnormal findings on cytological and histological examination of urine
R82.993: The spelling of “Hyperuricosuria” is corrected. S02.121A – S02.129S: Fracture of orbital roof
S02.831A – S02.849S: Fracture of orbital wall
S02.85XA – S02.85XS: Fracture of orbit, unspecified
T40.906A – T40.996S: [hallucinogens] is added to the descriptions.
T44.1X6A – T44.1X6S: [cholinergics] is added to the descriptions.
T50.911A – T50.916S: Multiple codes are added for poisoning, adverse effect, and underdosing.
T67.0XXA T67.01XA Heatstroke and sunstroke, initial encounter
T67.0XXD T67.01XD Heatstroke and sunstroke, subsequent encounter
T67.0XXS T67.01XS Heatstroke and sunstroke, sequela
T67.02XA Exertional heatstroke, initial encounter
T67.02XD Exertional heatstroke, subsequent encounter
T67.02XS Exertional heatstroke, sequela
V43.13XA – V43.13XS: The descriptions are changed to include the word “truck.” T67.09XA Other heatstroke and sunstroke, initial encounter
T67.09XD Other heatstroke and sunstroke, subsequent encounter
T67.09XS Other heatstroke and sunstroke, sequela
Y35.009A – Y35.99XS: Numerous codes are added for injuries involving Legal intervention.
Z01.020 Encounter for examination of eyes and vision following failed vision screening without abnormal findings
Z01.021 Encounter for examination of eyes and vision following failed vision screening with abnormal findings
Z11.7 Encounter for testing for latent tuberculosis infection
Z22.7 Latent tuberculosis
Z45.42: “Neuropacemaker” is changed to “neurostimulator” and brain, peripheral nerve, and spinal cord are removed.
Z68.43: Body mass index of 50 changes to 50.0.
Z71.84 Encounter for health counseling relating to travel
Z86.002 Personal history of in-situ neoplasm of other and unspecified genital organs
Z86.003 Personal history of in-situ neoplasm of oral cavity, esophagus and stomach
Z86.004 Personal history of in-situ neoplasm of other and unspecified digestive organs
Z86.005 Personal history of in-situ neoplasm of middle ear and respiratory system
Z86.006 Personal history of melanoma in-situ
Z86.007 Personal history of in-situ neoplasm of skin
Z86.15 Personal history of latent tuberculosis infection
Z96.82 Presence of neurostimulator

To understand the rationales for these ICD-10-CM code set updates, read the accompanying sidebar “New ICD-10-CM Code Rationales.”
Download the FY 2020 release of ICD-10-CM.

About the author:
Jean R. Pryor, CPMA, CPC, CPB, CPC-I, CRC, CIMC, CCS-P, CHAP, AAPC Fellow, is the administrator of coding and education at St. Elizabeth Physicians. She has more than 34 years of medical coding and billing experience, and she has been a CPC since 1994. Pryor was a master coder and auditor reviewing Medicare Advantage data for hierarchical condition categories, Risk Adjustment Processing System, secondary payments, and duplicate payment activities. She is a member of Cigna Government Services Provider Outreach Education Advisory Group. Pryor is the president of the Northern Kentucky local chapter and is Region 6 representative of the AAPC National Advisory Board.

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