ED Coding and Reimbursement Alert

The hits just keep on coming with ICD-10 2023.

Remember that ICD-10 2023 will feature:

• 1,468 new codes,
• 251 deleted codes,
• 35 revised codes, and
• 36 codes converted to parent.

And though we’ve covered ICD-10 codes already in ED Coding Alert, we’ve got more to talk about. Here is another set of diagnosis codes you’ll need to familiarize yourself with now, as ICD-10 2023 took effect on Oct. 1, 2022.

Thoracic AA Gets New Parents, ‘Children’

The codes we’ll cover in this story deal primarily with aortic aneurysm (AA) diagnoses. The first code set that ED coders should note is used to diagnose patients with thoracic AA.

Convert to parent: In ICD-10 2023, I71.1 (Thoracic aortic aneurysm, ruptured) is a parent code. This playful terminology refers to a code family which began with an original or “parent” code that over time developed into a broader code family. Check out how the parenting idea works in practice below:

New codes: The I71.1 parent will then “birth” these four new codes:

• I71.10 (Thoracic aortic aneurysm, ruptured, unspecified)
• I71.11 (Aneurysm of the ascending aorta, ruptured)
• I71.12 (Aneurysm of the aortic arch, ruptured)
• I71.13 (Aneurysm of the descending thoracic aorta, ruptured)

Convert to parent: In ICD-10 2023, I71.2 (Thoracic aortic aneurysm, without rupture) is a parent code.

New codes: The I71.2 parent code will lead to these new codes:

• I71.20 (Thoracic aortic aneurysm, without rupture, unspecified)
• I71.21 (Aneurysm of the ascending aorta, without rupture)
• I71.22 (Aneurysm of the aortic arch, without rupture)
• I71.23 (Aneurysm of the descending thoracic aorta, without rupture)

Impact: Both the I71.1- codes and the I71.2- codes add four options to specify where the thoracic AA occurred: unspecified, ascending aorta, aortic arch, or descending thoracic aorta.

Abdominal AAs Get Dx Upgrade

ICD-10 2023 will also change how you choose diagnoses for abdominal AAs.

Convert to Parent: In ICD-10 2023, I71.3 (Abdominal aortic aneurysm, ruptured) is a parent code.

New: The I71.3 parent code will lead to these new codes:

• I71.30 (Abdominal aortic aneurysm, ruptured, unspecified)
• I71.31 (Pararenal abdominal aortic aneurysm, ruptured)
• I71.32 (Juxtarenal abdominal aortic aneurysm, ruptured)
• I71.33 (Infrarenal abdominal aortic aneurysm, ruptured)

Convert to Parent: In ICD-10 2023, I71.4 (Abdominal aortic aneurysm, without rupture) is a parent code.

New: The I71.4 parent code will lead to these new codes:

• I71.40 (Abdominal aortic aneurysm, without rupture, unspecified)
• I71.41 (Pararenal abdominal aortic aneurysm, without rupture)
• I71.42 (Juxtarenal abdominal aortic aneurysm, without rupture)
• I71.43 (Infrarenal abdominal aortic aneurysm, without rupture)

Impact: Both the I71.3- and I71.4- codes add four options to specify where the abdominal AA occurred: unspecified, pararenal, juxtarenal, and infrarenal.

Thoracoabdominal AAs Get 6-Pack of New Codes

Finally on the AA front, ICD-10 2023 also added to the cache of codes you’ll use to report thoracoabdominal AAs.

Convert to parent: In ICD-10 2023, I71.5 (Thoracoabdominal aortic aneurysm, ruptured) is a parent code.

New: The I71.5 parent code will lead to these new codes:

• I71.50 (Thoracoabdominal aortic aneurysm, ruptured, unspecified)
• I71.51 (Supraceliac aneurysm of the abdominal aorta, ruptured)
• I71.52 (Paravisceral aneurysm of the abdominal aorta, ruptured)

Convert to parent: In ICD-10 2023. I71.6 (Thoracoabdominal aortic aneurysm, without rupture) is a parent code.

New: The I71.6 parent code will lead to these new codes:

• I71.60 (Thoracoabdominal aortic aneurysm, without rupture, unspecified)
• I71.61 (Supraceliac aneurysm of the abdominal aorta, without rupture)
• I71.62 (Paravisceral aneurysm of the abdominal aorta, without rupture)

Impact: Both the I71.5- and I71.6- codes add options to specify where the thoracoabdominal AA occurred: unspecified, supraceliac, and paravisceral.

ICD-10 Adds Codes for Injuries Due to CPR/Chest Compression

In addition to all of the AA codes that have been converted or debuted in ICD-10 2023, there’s also a host of new codes to account for injuries patients sustain as a result of cardiopulmonary resuscitation (CPR) or chest compression. The codes will reside below the M96.- (Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified) code.

These new codes are:

• M96.A (Fracture of ribs, sternum and thorax associated with compression of the chest and cardiopulmonary resuscitation)
• M96.A11 (Fracture of sternum associated with chest compression and cardiopulmonary resuscitation)
• M96.A21 (Fracture of one rib associated with chest compression and cardiopulmonary resuscitation)
• M96.A31 (Multiple fractures of ribs associated with chest compression and cardiopulmonary resuscitation)
• M96.A41 (Flail chest associated with chest compression and cardiopulmonary resuscitation)
• M96.A91 (Other fracture associated with chest compression and cardiopulmonary resuscitation)

Impact: These additions provide a lot more detail for the code set; previously, there were no codes specifically related to CPR/chest compression-related injuries. Previously, you probably would have had to opt for the general M96.89 (Other intraoperative and postprocedural complications and disorders of the musculoskeletal system) for these injuries.