ICD 10 Coding Alert

Look to Z Code additions for these situations.

Your neurosurgery practice depends on showing the correct documentation of your services for payer reimbursement. Employing these key ICD-10 code updates will go a long way in ensuring that the claims you submit are successfully paid.

See these Mid-Cervical Disc Disorder and Cyclical Vomiting Revisions

ICD-10 2020 will revise two conditions you may report in your neurosurgery practice — unspecified mid-cervical disc disorder and cyclical vomiting.

Unspecified mid-cervical disc disorder: Code M50.120 (Mid-cervical disc disorder, unspecified) will change to M50.120 (Mid-cervical disc disorder, unspecified level). Emphasis has been added to the code descriptor.

As you can see, the addition of the word “level” to the code descriptor adds further clarification about what exactly in unspecified.

Cyclical vomiting: You will also see revisions to two important cyclical vomiting codes. Take a look at the revisions (emphasis added):

• G43.A0 (Cyclical vomiting, in migraine, not intractable)
• G43.A1 (Cyclical vomiting, in migraine, intractable).

Don’t miss: The addition of the words “in migraine” to the above code descriptors offer more specificity to this condition by clarifying that the cyclical vomiting occurs during a migraine.

Bring Z-Code Changes Into Focus

Addition: ICD-10 2020 will give you a brand-new Z-code to represent the presence of a neurostimulator —  Z96.82 (Presence of neurostimulator). “This diagnosis code might be applied when an evaluation and management service is performed in which the generator is interrogated, but not adjusted or managed,” explains Gregory Przybylski, MD, immediate past chairman of neuroscience and director of neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center in Edison, New Jersey.

Don’t miss: This new code will also cover the following conditions:

• Presence of brain neurostimulator
• Presence of gastric neurostimulator
• Presence of peripheral nerve neurostimulator
• Presence of sacral nerve neurostimulator
• Presence of spinal cord neurostimulator
• Presence of vagus nerve neurostimulator.

Revision: Code Z45.42 (Encounter for adjustment and management of neuropacemaker (brain) (peripheral nerve) (spinal cord)) will be revised to Z45.42 (Encounter for adjustment and management of neurostimulator). As you can see, Z45.42 will now just be the code for the adjustment and management of a neurostimulator.

Code Z45.42 will also now include the following conditions:

• Encounter for adjustment and management of brain neurostimulator
• Encounter for adjustment and management of gastric neurostimulator
• Encounter for adjustment and management of peripheral nerve neurostimulator
• Encounter for adjustment and management of sacral nerve neurostimulator
• Encounter for adjustment and management of spinal cord neurostimulator
• Encounter for adjustment and management of vagus nerve neurostimulator.

Don’t Miss T-Code Updates

ICD-10 2020 will also add a few new T-codes. For example, category T50.9- (Poisoning by, adverse effect of and underdosing of other and unspecified drugs, medicaments and biological substances) will gain the following codes:

• T50.91- (Poisoning by, adverse effect of and underdosing of multiple unspecified drugs, medicaments and biological substances)
• T50.911 (Poisoning by multiple unspecified drugs, medicaments and biological substances, accidental (unintentional))
• T50.912 (… intentional self-harm)
• T50.913 (… assault)
• T50.914 (… undetermined)
• T50.915 (Adverse effect of multiple unspecified drugs, medicaments and biological substances)
• T50.916 (Underdosing of multiple unspecified drugs, medicaments and biological substances).