General Surgery Coding Alert
Prepare for 2024 Dx Codes Relevant to Your General Surgery Practice
Apply these changes beginning Oct. 1 With almost 400 ICD-10-CM code additions and many deletions and revisions that go into effect on Oct. 1, you need to get ready for the changes that will impact your practice. We’re here to help you focus on what you need to know for clean surgical claims that show medical necessity using the most current, accurate diagnosis codes. Bonus: Medicare quality reporting programs also rely on appropriate diagnosis coding to evaluate appropriate procedures — so missing the boat now could impact your bottom line later. Update Pathologic Fracture Coding Beginning Oct. 1, you’ll have new, more specific codes for reporting a pathologic fracture of the pelvis, as follows: Analysis: These codes add further anatomical specificity to the pathological fracture ICD-10-CM codes. Previously, there was no way to identify the location of the fracture in the patient’s pelvis. Definition: Remember, a pathological fracture is a type of injury 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. When surgeons submit a bone specimen for pathological examination and diagnosis, you should be sure to identify the osteoporosis condition and laterality to allow for accurate ICD-10-CM code assignment, according to R.M. Stainton Jr., MD, president of Doctors’ Anatomic Pathology Services in Jonesboro, Arkansas. 7th character alert: Clinicians should provide the details to allow reporting these codes to the 7th character using one of these options: Don’t miss: When surgeons excise tissue for pathological examination, coders should always wait for the pathology report to assign the final diagnosis. Focus Sepsis Complication Coding If you’ve ever encountered the need to report sepsis following a surgical procedure, you should be familiar with changes coming down the pike on Oct. 1. ICD-10-CM 2024 adds more specificity for post procedural sepsis coding, no longer directing you to T81.4- (Infection following a procedure) in favor of “if applicable, postprocedural sepsis (T81.44-, Sepsis following a procedure) and T80.211- (Bloodstream infection due to central venous catheter). You’ll also have a new code for sepsis due to a non-strep organism: A41.54 (Sepsis due to Acinetobacter baumannii). Convert G20 to Parent Code If your surgeons deal with Parkinson’s disease patients, such as creating a stoma for a percutaneous endoscopic gastrostomy with jejunal tube for Duopa therapy, you should be aware of new, relevant ICD-10-CM codes. Beginning Oct. 1, code G20 (Parkinson’s disease) converts to a parent code for the following, more specific new codes: Analysis: With all the disease variability, G20 was the only code for Parkinson’s disease in the ICD-10-CM code book before 2024. These updates will make Parkinson’s coding more specific by adding information about dyskinesia and fluctuations. “Greater specificity in Parkinson’s disease is helpful in tracking treatments of this condition. Given that Parkinson’s disease has several manifestations in a patient’s condition and function, greater granularity in the diagnosis codes will help track how the various manifestations of Parkinson’s disease responds to various treatments,” says Gregory Przybylski, MD, Chairman of Neuroscience at the New Jersey Neuroscience Institute, JFK University Medical Center in Edison, New Jersey, any expansion of the Parkinson’s codes is a positive. Surgeons will need the clinical information from the ordering physician to accurately apply these new code options. Greet New Desmoid Tumor Codes Another new group of codes for 2024 describes desmoid tumors, which are rare lesions that may afflict various parts of the human anatomy. Desmoid tumors develop in the connective tissue, which is the tissue that supports and connects various structures in the body. These tumors can occur anywhere in the body, but they most commonly develop in the abdominal wall, shoulder, or thigh. Prior to the addition of these codes, you might have reported a desmoid tumor using D48.1 (Neoplasm of uncertain behavior of connective and other soft tissue). When your surgeon identifies one of these tumors, you should take note of these new codes when ICD-10 2024 takes effect Oct. 1: Capture Detailed History of Colon Polyp ICD-10-CM 2024 extends the Z83.71 (Family history of colonic polyps) family for greater specificity with the following codes: Clinicians may report these codes to show medical necessity for colonoscopy and possible biopsy that occurs more frequently than screening coverage rules allow.
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