Practice Management Alert

Get to know what’s new for next year, and see more accurate and more profitable coding.

CMS recently released the finalized 2018 update for ICD-10-CM, its domestic clinical modification of the tenth revision of the International Classification of Diseases published by the World Health Organization. This coders’ bible governs all patient interactions for the year beginning Oct. 1, 2017.

ICD-10-CM already features more than five times as many codes as its predecessor, allowing for much more diagnostic specificity. This 2018 update further enables that laser accuracy, with more than 350 new codes, 150 deleted codes, and 225 revisions to existing codes.

Here’s an overview of the most important changes to know for 2018:

• Substance abuse. It will now be possible to code for remission from specific drugs, as well as how severe that remission is (which helps to square the ICD-10-CM with the psychiatric DSM-5).
• Diabetes. There are new codes for diabetic ketoac­idosis, with and without coma.
• Heart disease. Several new codes distinguish between different kinds of heart failure (acute vs. chronic, for example) and myocardial infarction.
• Vision. Eye care physicians will now be able to identify low vision and blindness specific to each eye, and to differentiate between causes of degenerative myopia.
• Pregnancy. Plenty of new encounter codes for antenatal screenings help to identify what issues the OB-GYN is investigating. Other codes specify which side of the body a dangerous ectopic pregnancy is found on.
• Digestive health. Gastroenterologists can now get more specific about intestinal obstructions, including the extent of the blockage.
• Dermatology. Dozens of new codes address non-pressure chronic ulcers without necrosis for a range of locations on the body.
• Growths. New categories of neoplasms are added, and lumps in the breast are now narrowed down by quadrant.

This list only offers a taste of the changes in this 2018 update. For a full rundown, read CMS’ release at https://www.cms.gov/Medicare/Coding/ICD10/2018-ICD-10-CM-and-GEMs.html. Codify members can see the changes organized by specialty at https://www.aapc.com/codes/icd10cm-code-changes-2018.