ED Coding and Reimbursement Alert
Pathological Fx, FB Sensation Highlight New Code List
Get ready for more migraine codes. ICD-10 is at it again. In a summertime tradition, the list of diagnosis code additions/deletions/revisions is out. Now that it’s available, it’s up to coders to familiarize themselves with the new code list. The lowdown: The ICD-10 2024 addendum includes about 500 new codes, with another 30 or so revised codes. And while there are no revised codes relevant to ED, there’s still plenty for ED coders to digest before the new codes become effective on Oct. 1, 2023. In many specialties, there will be a concentrated, related set of ICD-10 codes that the coder can study. The breadth of diagnoses that EDs see prevents that neatness, however. As a result, the codes in this story vary wildly. Check out the new codes you’ll want to learn most — from new epilepsy codes to a new toxic effects code set. ICD-10 Adds to Epilepsy, Migraine Dx List We’ll take a look at the new codes affecting EDs in the order that they will appear in the code book in 2024. The first set of codes involves a new epilepsy designation. New Codes Analysis: These additions provide another layer to the G40.- (Epilepsy and recurrent seizures) code group, which is already considerable. It represents a type of epilepsy that didn’t previously have specific codes; and these codes account for intractable/not intractable and with/without status epilepticus. For those unfamiliar with the condition, Lafora progressive myoclonus epilepsy is a type of epilepsy characterized by seizures and progressive neurological deterioration. It is a rare genetic disorder that usually begins in adolescence and is caused by mutations in certain genes. The seizures in Lafora progressive myoclonus epilepsy are often myoclonic, which means they involve sudden, brief muscle jerks. Other symptoms may include cognitive decline, difficulty with coordination and balance, and visual hallucinations. New Codes Analysis: Much like the new epilepsy codes, the new migraine codes add another layer to the already deep field of G43.- (Migraine) codes. Before 2024, chronic migraine with aura did not have its own code set. In 2024, you’ll be able to code for chronic migraine with aura, and you can further specify that diagnosis by answering the intractable/not intractable and status migrainosus questions. Remember, chronic migraine is a condition characterized by the presence of a headache on 15 or more days per month for at least three months, with at least eight of those headaches being migraines. Also, migraine with aura refers to a set of neurological symptoms that some individuals experience before or during a migraine. These symptoms typically occur gradually and can last for a few minutes to an hour. Migraine aura can manifest as various sensory disturbances, such as visual changes (flashing lights, blind spots, zigzag lines), tingling or numbness in the face or limbs, difficulty speaking, or even temporary loss of vision. New Codes Analysis: These codes will be added to the H57.8- (Other specified disorders of eye and adnexa) code set, and will allow for greater specificity when a patient feels like they a foreign body (FB) in their eye but don’t. New Codes Analysis: These codes are part of the J44.- (Other chronic obstructive pulmonary disease) code set, and will allow for more specific reporting of “other” chronic obstructive pulmonary disease (COPD). Previously, you’d have had to rely on J44.9 (Chronic obstructive pulmonary disease, unspecified) for all the above diagnoses. New Codes Analysis: These codes add further anatomical specificity to the pathological fracture ICD-10 codes. previously, there was no way to specify that the fracture was to the patient’s pelvis. Definition: Remember, a pathological fracture is a type of fracture that occurs in a bone that has been weakened by an underlying disease or condition. It is different from a typical fracture that occurs due to trauma or injury. In a pathological fracture, the bone breaks more easily because it has been compromised by an existing condition, such as osteoporosis or a tumor. New Codes Analysis: ICD-10 will place these codes in the R09.- (Other symptoms and signs involving the circulatory and respiratory system) code set, providing greater specificity when a patient feels there is a foreign body in the listed areas, but there is none present. New Codes Analysis: These codes reside in Chapter 19: “Injury, Poisoning, and Certain Other Consequences of External Causes.” More specifically, they will be part of the T56.8- (Toxic effects of other metals) code set. Definition: Gadolinium is a rare earth metal that is commonly used in medical imaging procedures, specifically in magnetic resonance imaging (MRI). Gadolinium-based contrast agents (GBCAs) are injected into the patient’s bloodstream to enhance the visibility of certain tissues or blood vessels during an MRI scan. These contrast agents contain gadolinium ions that interact with the magnetic field of the MRI machine, producing a clearer and more detailed image.
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