ICD 10 Coding Alert

Find out which codes you can add to your M45 options.

It’s that time of year again: new ICD-10 codes are being released, and you’ll need to know the adjustments to keep coding accurately. The World Health Organization (WHO) has released its latest list of ICD-10 codes. The new codes will go into effect on Oct. 1, 2021, and remain in effect until Oct. 1, 2022.

Check out the codes that are likely to be important for neurology and pain management coders.

Eye These Numbers

According to the WHO, the new code book will have:

• 191 new ICD-10 codes,
• 27 revised ICD-10 codes, and
• 25 deleted codes.

Impact: For neurology and pain management coders, there are more than 30 new codes that could impact the way you select diagnoses in the future. While there are no deleted codes of note, there are also a few revised codes you’ll want to note before October 1.

Find New Options for Depression, Cervicogenic Headache Codes

Here’s a list of the new ICD-10 codes you’ll need to learn this summer, along with some analysis interspersed for better guidance:

• F32.A (Depression, unspecified)
• G04.82 (Acute flaccid myelitis)
• G44.86 (Cervicogenic headache)
• G92.8 (Other toxic encephalopathy)
• G92.9 (Unspecified toxic encephalopathy)

Analysis: The G44.86 code will allow you to code cervicogenic headache when the provider diagnoses it. Previously, you would have had to code cervicogenic headaches with a less specific code from the G44.8 (Other specified headache syndromes) code set.

• M35.05 (Sjogren syndrome with inflammatory arthritis)
• M35.06 (Sjogren syndrome with peripheral nervous system involvement)
• M35.07 (Sjogren syndrome with central nervous system involvement)
• M35.08 (Sjogren syndrome with gastrointestinal involvement)
• M35.0A (Sjogren syndrome with glomerular disease)
• M35.0B (Sjogren syndrome with vasculitis)
• M35.0C (Sjogren syndrome with dental involvement)

Analysis: At first glance, it doesn’t seem that Sjogren syndrome would be relevant to neurology or pain management coders; the condition is marked by dry eyes and dry mouth, which won’t be treated by any of your providers. You will, however, probably see people with rheumatoid arthritis (RA), inflammatory arthritis, or peripheral/central nervous system issues. These patients often suffer from Sjogren syndrome due to their primary conditions, so these could be frequent secondary diagnoses for some of your patients.

• M45.A (Non-radiographic axial spondyloarthritis)
• M45.A0 (Non-radiographic axial spondyloarthritis of unspecified sites in spine)
• M45.A1 (Non-radiographic axial spondyloarthritis of occipito-atlanto-axial region)
• M45.A2 (Non-radiographic axial spondyloarthritis of cervical region)
• M45.A3 (Non-radiographic axial spondyloarthritis of cervicothoracic region)
• M45.A4 (Non-radiographic axial spondyloarthritis of thoracic region)
• M45.A5 (Non-radiographic axial spondyloarthritis of thoracolumbar region)
• M45.A6 (Non-radiographic axial spondyloarthritis of lumbar region)
• M45.A7 (Non-radiographic axial spondyloarthritis of lumbosacral region)
• M45.A8 (Non-radiographic axial spondyloarthritis of sacral and sacrococcygeal region)
• M45.AB (Non-radiographic axial spondyloarthritis of multiple sites in spine)

Analysis: These additions almost double the coding options you’ll have for the M45 (Ankylosing spondylitis) code set.

• M54.50 (Low back pain, unspecified)
• M54.51 (Vertebrogenic low back pain)
• M54.59 (Other low back pain)

Analysis: This provides greater specificity for patients with low back pain; the 2021 ICD-10 code book only lists a single code under M54.5- (Low back pain).

• S06.A (Traumatic brain compression and herniation)
• S06.A0 (Traumatic brain compression without herniation)
• S06.A0XA (Traumatic brain compression without herniation, initial encounter)
• S06.A0XD (Traumatic brain compression without herniation, subsequent encounter)
• S06.A0XS (Traumatic brain compression without herniation, sequela)
• S06.A1 (Traumatic brain compression with herniation)
• S06.A1XA (Traumatic brain compression with herniation, initial encounter)
• S06.A1XD (Traumatic brain compression with herniation, subsequent encounter)
• S06.A1XS (Traumatic brain compression with herniation, sequela)

Analysis: These codes will almost double the S06.0 (Concussion) code set.

Note Revised Codes for Depressive Episode, Sjogren Syndrome

The following codes are being revised for the next ICD-10 (revised definitions shown here):

• F32 (Depressive episode)
• M35.0 (Sjogren syndrome)
• M35.00 (Sjogren syndrome, unspecified)
• M35.01 (Sjogren syndrome with keratoconjunctivitis)
• M35.02 (Sjogren syndrome with lung involvement)
• M35.03 (Sjogren syndrome with myopathy)
• M35.04 (Sjogren syndrome with tubulo-interstitial nephropathy)
• M35.09 (Sjogren syndrome with other organ involvement)

Analysis: These revisions make coding for Sjogren syndrome simpler. The M35.0 (Sicca syndrome [Sjogren]) codes currently reference Sicca syndrome; Sjogren syndrome will replace this term in the revised codes.