Podiatry Coding & Billing Alert

ICD-10-CM 2021:

New Rheumatoid Arthritis and Osteoporosis Codes Highlight Your Podiatry Changes for 2021

Hint: COVID-19 code U07.1 will officially be recorded in ICD-10-CM coding manual.

CMS recently released the new ICD-10-CM 2021 codes. Although these codes won’t go into effect until Oct. 1, 2020, now is the perfect time to prepare your podiatry practice.

Read on to learn more about these new ICD-10-CM codes.

Turn to U07.1 for COVID-19

In October, U07.1 (COVID-19) will be recorded in the ICD-10-CM 2021 manual. However, this is just a formality since the code has been official since April. Experts were amazed at the speed with which U07.1 was added to ICD-10-CM — but it made sense considering the unprecedented public health emergency (PHE) and the lack of an accurate diagnosis code for the situation.

“The speed that the ICD-10-CM Coordination and Maintenance Committee approved this new code is unprecedented,” says Betty Ann Price, BSN, RN, president and founder of Professional Reimbursement and Coding Strategies, and AHIMA-approved ICD-10-CM trainer. “The new code, U07.1, was initially assigned by the World Health Organization. Usually it requires at least a one-year process to get a new code adopted, but this went through with exceptional speed.”

The early adoption of U07.1 was necessary to “fulfill the imperative need to track the diagnosis of this condition as well as its subsequent treatment,” says Gregory Przybylski, MD, immediate past chairman of neuroscience and director of neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center in Edison, New Jersey.

Notes beneath U07.1 instruct you to use an additional code to “identify pneumonia or other manifestations.” There are also several Excludes1 diagnoses as well, such as:

  • B34.2 (Coronavirus infection, unspecified)
  • B97.2- (Coronavirus as the cause of diseases classified elsewhere)
  • J12.81 (Pneumonia due to SARS-associated coronavirus)

Observe New ‘A’ Option Added to These Arthritis Codes

ICD-10-CM 2021 will add several codes with an “A” character to some of the sets in the Diseases of the musculoskeletal system and connective tissue (M00-M99) Chapter. For example, M05.7- (Rheumatoid arthritis with rheumatoid factor without organ or systems involvement) will add M05.7A (Rheumatoid arthritis with rheumatoid factor of other specified site without organ or systems involvement) to give you another fifth-character option for this condition.

And, M05.8 (Other rheumatoid arthritis with rheumatoid factor) will add M05.8A (Other rheumatoid arthritis with rheumatoid factor of other specified site).

Other new codes from this set include:

  • M06.0A (Rheumatoid arthritis without rheumatoid factor, other specified site)
  • M06.8A (Other specified rheumatoid arthritis, other specified site)
  • M08.0A (Unspecified juvenile rheumatoid arthritis, other specified site)
  • M08.2A (Juvenile rheumatoid arthritis with systemic onset, other specified site)
  • M08.4A (Pauciarticular juvenile rheumatoid arthritis, other specified site)
  • M08.9A (Juvenile arthritis, unspecified, other specified site)

Mark Down New Character ‘9’ in New Codes

ICD-10 will also add the fifth-character option of “9” or “A” to several other code sets. For example, ICD-10 will add M19.09 (Primary osteoarthritis, other specified site) to the M19.0- (Primary osteoarthritis of other joints) code set in October. Also, M19.1- (Post-traumatic osteoarthritis of other joints) will add M19.19 (Post-traumatic osteoarthritis, other specified site).

Other new codes from this set include:

  • M19.29 (Secondary osteoarthritis, other specified site)
  • M24.19 (Other articular cartilage disorders, other specified site)
  • M24.29 (Disorder of ligament, other specified site)
  • M24.39 (Pathological dislocation of other specified joint, not elsewhere classified)
  • M24.49 (Recurrent dislocation, other specified joint)
  • M24.59 (Contracture, other specified joint)
  • M24.89 (Other specific joint derangement of other specified joint, not elsewhere classified)
  • M25.39 (Other instability, other specified joint)
  • M25.59 (Pain in other specified joint)
  • M25.69 (Stiffness of other specified joint, not elsewhere classified)
  • M80.0A (Age-related osteoporosis with current pathological fracture, other site)
  • M80.8A (Other osteoporosis with current pathological fracture, other site)

Pinpoint New External Cause Codes

ICD-10-CM 2021 will also add some new external cause codes to your coding arsenal. For example, take a look at some of the new injured pedestrian codes:

  • V00.03- (Pedestrian on foot injured in collision with standing micro-mobility pedestrian conveyance)
  • V00.031- (Pedestrian on foot injured in collision with rider of standing electric scooter)
  • V00.038- (Pedestrian on foot injured in collision with rider of other standing micro-mobility pedestrian conveyance). Note: This code includes a pedestrian on foot injured in collision with rider of hoverboard or rider of Segway.
  • V06.03- (Pedestrian on standing micro-mobility pedestrian conveyance injured in collision with other nonmotor vehicle in nontraffic accident)
  • V06.031- (Pedestrian on standing electric scooter injured in collision with other nonmotor vehicle in nontraffic accident)
  • V06.038- (Pedestrian on other standing micro-mobility pedestrian conveyance injured in collision with other nonmotor vehicle in nontraffic accident). Note: This code includes a pedestrian on a hoverboard or Segway injured in a collision with other nonmotor vehicles in a nontraffic accident.

Remember: Although not nationally mandated, external cause codes V00- (Pedestrian conveyance accident) through Y99- (External cause status) can be vitally important to your claims because they show a broader picture of patients’ health conditions.

However, you should never sequence an external cause code as the first-listed or principal diagnosis on your claims. Instead, you should use these external cause codes as secondary codes to provide additional information such as the cause, intent, place where the vent occurred, activity of the patient at the time of the event, and the patient’s status.