Cardiology Coding Alert

Don’t miss the new ecstasy poisoning codes.

In the article “You’ll Find New Cerebral Infarction, Cerebrovascular Disease Codes on Oct. 1” in Cardiology Coding Alert Vol. 21 No. 8, you learned some of the ICD-10 2019 changes you will see on Oct. 1, 2018.

Read on to learn about even more new ICD-10 codes, so you won’t be left in the dark this fall.

Mark Down These External Cause Code Changes

T codes are part of Chapter 19, Injury, poisoning and certain other consequences of external causes. Here are some areas to note from the T code additions and changes:

Ecstasy poisoning additions: Watch for options to report ecstasy poisoning under new subcategory T43.64- (Poisoning by ecstasy). Your new choices are as follows:

• T43.641X (Poisoning by ecstasy, accidental (unintentional))
• T43.642X (Poisoning by ecstasy, intentional self-harm)
• T43.643X (Poisoning by ecstasy, assault)
• T43.644X (Poisoning by ecstasy, undetermined).

Don’t miss: Codes in category T43- (Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified) require a seventh character. Your choices are as follows:

• A (Initial encounter)
• D (Subsequent encounter)
• S (Sequela).

Caution: Don’t forget about notes with codes. For example, T74.3 (Psychological abuse, confirmed) has new notes clarifying that the code is appropriate for “Bullying and intimidation, confirmed” and “Intimidation through social media, confirmed.”

Confirmed forced labor/sexual exploitation additions: Check for new code additions specific to confirmed forced labor and forced sexual exploitation. These codes include T74.5- (Forced sexual exploitation, confirmed) through T74.62XS (Child forced labor exploitation, confirmed, sequela). Instructions with codes from category T74- (Adult and child abuse, neglect and other maltreatment, confirmed) tell you to report an additional code, if applicable to identify any associated current injury. You should also report an additional external cause code to identify the perpetrator if known (Y07.-).

Suspected forced labor/sexual exploitation additions: You will also see new codes for suspected forced labor and forced sexual exploitation T76.5- (Forced sexual exploitation, suspected) through T76.62XS (Child forced labor exploitation, suspected, sequela). Instructions with codes from category T76- (Adult and child abuse, neglect and other maltreatment, suspected) tell you if applicable to report an additional code to identify any associated current injury.

Infection and sepsis additions: Notice that codes T81.40- (Infection following a procedure, unspecified) through T81.43XS (Infection following a procedure, organ and space surgical site, sequela) and T81.49XX (Infection following a procedure, other surgical site) added to category T81- (Complications of procedures, not elsewhere classified). And, don’t miss new sepsis code T81.44XX (Sepsis following a procedure).

Adopt These New Z Codes

Z codes are part of Chapter 21, Factors influencing health status and contact with health services. Z codes represent reasons for encounter, and you must report a corresponding procedure code with a Z code if the physician performs the procedure, according to ICD-10 instructions.

ICD-10 2019 will add multiple Z codes you need to be aware of including Z04.81 (Encounter for examination and observation of victim following forced sexual exploitation); Z13.3 (Encounter for screening examination for mental health and behavioral disorders); Z20.821 (Contact with and (suspected) exposure to Zika virus); and Z62.813 (Personal history of forced labor or sexual exploitation in childhood).

In addition, ICD-10 2019 will also add new Z codes for family history of lipoproteins. They are as follows:

• Z83.43- (Family history of other disorder of lipoprotein metabolism and other lipidemias)
• Z83.430 (Family history of elevated lipoprotein(a))
• Z83.438 (Family history of other disorder of lipoprotein metabolism and other lipidemia).

Check Out Path and Lab Additions

Additions: Take a look at these new cardiology path and lab cardiology additions. They are as follows:

• E78.41 (Elevated Lipoprotein(a))
• E78.49 (Other hyperlipidemia)
• E88.02 (Plasminogen deficiency).

Expand Your Cannabis-Related Disorder Options

Additions: ICD-10 2019 will add two new codes to the mental, behavioral, and neurodevelopmental disorders chapter of ICD-10 in category F12- (Cannabis related disorders). They are as follows:

• F12.23 (Cannabis dependence with withdrawal)
• F12.93 (Cannabis use, unspecified with withdrawal).

These new codes will be join the ranks of current codes F12.220 (Cannabis dependence with intoxication, uncomplicated) and F12.250 (Cannabis dependence with psychotic disorder with delusions).