Dermatology Coding Alert

Proposed list would introduce nearly 2,000 new codes, effective Oct. 1.

Six months after ICD-10 became official, coders in most specialties are preparing for the possibility of adding nearly 2,000 new diagnosis codes to the list.

On April 27, the Federal Register printed the proposed new, revised and deleted ICD-10 codes that will go into effect on Oct. 1, 2016 – and the list includes a startling 1,900 new diagnosis codes that will end the partial freeze that the CDC has had in place since 2011.

However: The “diseases of the skin and subcutaneous tissue” series, L00-L99, would see only a few additions and revisions.

Most of the revisions have to do with the introduction of new diagnosis codes describing hematoma of skin and subcutaneous tissue following a procedure:

• L76.31 – Postprocedural hematoma of skin and subcutaneous tissue following a dermatologic procedure
• L76.32 – … following other procedure.

 Currently, there are codes for postprocedural hematoma – but they are combined with postprocedural hemorrhage:

• L76.21 – Postprocedural hemorrhage and hematoma of skin and subcutaneous tissue following a dermatologic procedure
• L76.22 – … following other procedure.

On Oct. 1, however, ICD-10 will delete the words “and hematoma” from L76.21 and L76.22. For postprocedural hemorrhage of skin and subcutaneous tissue, you will report L76.21 or L76.22. For postprocedural hematoma, report L76.31 or L76.32.

The same pattern will be evident for postprocedural hematomas in many other parts of the body. For example, on Oct. 1, these codes will debut:

• D78.31 – Postprocedural hematoma of the spleen following a procedure on the spleen
• E89.820 – Postprocedural hematoma of an endocrine system organ or structure following an endocrine system procedure
• H59.331 – Postprocedural hematoma of right eye and adnexa following an ophthalmic procedure.

These codes precede partner diagnoses that are proposed to debut on Oct. 1, 2017, which will specifically describe post-procedural seromas to differentiate between seromas and hematomas. “Currently, postoperative seroma would be coded with postoperative hematoma,” according to the meeting minutes from the CDC’s March ICD-10 Coordination and Maintenance Committee Meeting. However, next year each condition should have its own code set, the meeting minutes reveal.

Another new code, L98.7 (Excessive and redundant skin and subcutaneous tissue), describes loose or sagging skin following weight loss, either through bariatric surgery or organically through diet.

Fair warning: Although the list of new and revised codes has been posted on the CDC and CMS websites, it is “NOT the final list,” notes Sue Bowman, MJ, RHIA, CCS, FAHIMA, Senior Director of Coding Policy and Compliance at AHIMA. “The Addenda to be published in June is the complete, final list of code changes going into effect this October.”

Learn more: For more ICD-10 information, visit www.cms.gov/Medicare/Coding/ICD10. For a complete list of the ICD-10 additions, deletions, and revisions, visit http://1.usa.gov/22ZxeNI.