Anesthesia Coding Alert

Pay attention to new options for annulus fibrosus defect, endometriosis.

Updates to ICD-10-CM for fiscal year (FY) 2023 are available for you to begin familiarizing yourself with before they go into effect on Oct. 1. The files contain 1,468 new diagnosis codes, 251 deletions, and 35 revisions.

As an anesthesia coder, your providers can be involved with care for patients diagnosed with any condition. Rather than focusing on particular sections of ICD-10-CM like subspecialty coders might, you should spend time looking through all the changes since any diagnosis might cross your desk, advises Kelly D. Dennis, MBA, ACS-AN, CANPC, CHCA, CPC, CPC-I, owner of Perfect Office Solutions in Leesburg, Florida.

Take Note of New M51.- Intervertebral Diagnoses

If you report pain management services, several new codes related to intervertebral annulus fibrosus defects could be of interest.

• M51.A0 (Intervertebral annulus fibrosus defect, lumbar region, unspecified size)
• M51.A1 (… small, lumbar region)
• M51.A2 (… large, lumbar region)
• M51.A3 (… lumbosacral region, unspecified size)
• M51.A4 (… small, lumbosacral region)
• M51.A5 (… large, lumbosacral region)

What it is: The annulus fibrosus is a series of 15-25 concentric rings made of lamellar (thin layer) fibrocartilaginous tissue. Peripheral fibers of the annulus fibrosus help anchor the intervertebral discs to the vertebrae. Repairing any annulus fibrosus defects is critical to preventing intervertebral disc degeneration.

Get Specific With Endometriosis Options

The new ICD-10-CM code set includes almost 200 diagnoses related to endometriosis — and many could be for anatomic sites you’ve never connected with endometriosis.

What it is: Endometriosis is a disorder in which tissue similar to the endometrium (the tissue that normally lines the inside of the uterus) grows outside the uterus. Endometriosis most commonly involves the ovaries, fallopian tubes, and the tissue lining the pelvis.

New diagnosis codes represent endometriosis in these areas, but many represent the condition in less common sites beyond the pelvic organs: the abdomen, cardiothoracic space, and more.

With more than 150 new codes related to endometriosis, you’ll need to know the anatomic site as well as the severity of the condition when selecting the correct diagnosis. Although some descriptors simply mention endometriosis, others specify “superficial” or “deep” endometriosis.

Example 1: Diagnoses for endometriosis of many anatomic sites follow this structure for the right ovary:

• N80.101 (Endometriosis of right ovary, unspecified depth)
• N80.111 (Superficial endometriosis of right ovary)
• N80.121 (Deep endometriosis of right ovary).

There also are diagnoses for unspecified depth, unspecified ovary, and bilateral conditions.

Example 2: If you code for pain management services, a few of the endometriosis codes apply to nerves:

• N80.D4 (Endometriosis of the sciatic nerve)
• N80.D5 (Endometriosis of the pudendal nerve)
• N80.D6 (Endometriosis of the femoral nerve)
• N80.D9 (Endometriosis of other pelvic nerve)

View all the 2023 ICD-10-CM information on the CMS website at www.cms.gov/medicare/icd-10/2023-icd-10-cm.

Remember: ICD-10-CM for FY 2023 should be used for patient encounters and discharges from Oct. 1, 2022, through Sept. 30, 2023.