Cardiology Coding Alert

Dig into new atrial fibrillation codes I48.11 and I48.19.

CMS recently published its list of the new ICD-10 2020 codes, but they won’t go into effect until Oct. 1, 2019. Read on to check out how these new codes and revisions will impact your cardiology practice’s bottom line.

Notice 4 New Atrial Fibrillation Codes

ICD-10 2020 will give you four new codes for atrial fibrillation:

• For longstanding persistent atrial fibrillation, you can now report I48.11 (Longstanding persistent atrial fibrillation). “I am very excited to have this new code for longstanding persistent atrial fibrillation because, in my experience, I have seen this diagnosis a lot,” says Christina Neighbors, MA, CPC, CCC, Coding Quality Auditor for Conifer Health Solutions, Coding Quality & Education Department, and member of AAPC’s Certified Cardiology Coder steering committee. “The added specificity for atrial fibrillation will be so helpful for coders.”
• I48.19 (Other persistent atrial fibrillation). This code will include NOS chronic persistent atrial fibrillation and persistent atrial fibrillation.
• I48.21 (Permanent atrial fibrillation). Don’t miss: The condition “permanent atrial fibrillation” will no longer be a covered condition under current code I48.2 (Chronic atrial fibrillation). Instead, permanent atrial fibrillation gains its own, specific code in I48.21.
• I48.20 (Chronic atrial fibrillation, unspecified).

Highlight Pulmonary Embolism Options

You will also see two new codes for pulmonary embolisms. They are as follows:

• I26.93 (Single subsegmental pulmonary embolism without acute cor pulmonale). This condition will include NOS subsegmental pulmonary embolism.
• I26.94 (Multiple subsegmental pulmonary emboli without acute cor pulmonale).

These new codes give you more reporting specificity by adding a fifth character to existing code I26.9 (Pulmonary embolism without acute cor pulmonale).

Take Note of Atherosclerosis Revisions

Two revisions you will see for atherosclerosis of native arteries in the leg will merely remove a redundant word.

For example: The descriptor for I70.238 will change to I70.238 (Atherosclerosis of native arteries of right leg with ulceration of other part of lower right leg). (Emphasis added).

The code for atherosclerosis of the left leg with ulceration, I70.248, will see the same change.

Observe Acute, Chronic Embolism and Thrombosis Additions

ICD-10 2020 will also add two new categories for acute embolisms and thrombosis — peroneal vein and calf muscular vein.

Peroneal Vein: The new category for acute embolism and thrombosis of the peroneal vein is I82.45- (Acute embolism and thrombosis of peroneal vein). The new codes are as follows:

• I82.451 (Acute embolism and thrombosis of right peroneal vein)
• I82.452 (… of left peroneal vein)
• I82.453 (… of peroneal vein, bilateral)
• I82.459 (… of unspecified peroneal vein).

You will also see new chronic codes for the same above conditions. For category I82.55- (Chronic embolism and thrombosis of peroneal vein) you will have the following options:

• I82.551 (Chronic embolism and thrombosis of right peroneal vein)
• I82.552 (… of left peroneal vein)
• I82.553 (… of peroneal vein, bilateral)
• I82.559 (… of unspecified peroneal vein).

Calf muscular vein: The new category for acute embolism and thrombosis of the calf muscular vein is I82.46- (Acute embolism and thrombosis of calf muscular vein). The codes are as follows:

• I82.461 (Acute embolism and thrombosis of right calf muscular vein)
• I82.462 (… of left calf muscular vein)
• I82.463 (… of calf muscular vein, bilateral)
• I82.469 (… of unspecified calf muscular vein).

Also, for category I82.56- (Chronic embolism and thrombosis of calf muscular vein), you will have the following additions:

• I82.561 (Chronic embolism and thrombosis of right calf muscular vein)
• I82.562 (… of left calf muscular vein)
• I82.563 (… thrombosis of calf muscular vein, bilateral)
• I82.569 (… of unspecified calf muscular vein).

Catch T and Z Code Additions

ICD-10 2020 will add a few new T-codes. For example, category T50.9- (Poisoning by, adverse effect of and underdosing of other and unspecified drugs, medicaments and biological substances) will gain the following codes:

• T50.91- (Poisoning by, adverse effect of and underdosing of multiple unspecified drugs, medicaments and biological substances)
• T50.911 (Poisoning by multiple unspecified drugs, medicaments and biological substances, accidental (unintentional))
• T50.912 (… intentional self-harm)
• T50.913 (… assault)
• T50.914 (… undetermined)
• T50.915 (Adverse effect of multiple unspecified drugs, medicaments and biological substances)
• T50.916 (Underdosing of multiple unspecified drugs, medicaments and biological substances).

You will also see a few new Z-codes, which represent factors influencing health status and contact with health services. They are as follows:

• Z71.84 (Encounter for health counseling related to travel)
• Z86.006 (Personal history of melanoma in-situ)
• Z86.007 (Personal history of in-situ neoplasm of skin).

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