MDS Alert

Look for lots of new options for coding aortic aneurysms.

Remember, new ICD-10-CM codes go into effect Oct. 1, annually. Take careful note of these new codes and other code updates to make sure your diagnosis code assignments for these conditions remain accurate.

Look for 22 new aortic aneurysm codes, eight atherosclerosis additions, and four dissection of aorta codes, and make sure you use them, when appropriate, after Oct. 1!

Find Out Your Options for Aortic Aneurysms

In 2023, you will gain the following new thoracic, abdominal, and thoracoabdominal aortic aneurysm codes:

Thoracic aortic aneurysm:

• 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)
• 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)

Abdominal aortic aneurysm:

• 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)
• 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)

Thoracoabdominal aortic aneurysm:

• 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)
• 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)

Ruptured aneurysm: As you can see, the new aortic aneurysm codes are distinguished between whether there was a rupture. Codes I71.10 through I71.13, I71.30 through I71.33, and I71.50 through I71.52 will offer more specificity when the resident has a ruptured aortic aneurysm.

No rupture: On the other hand, codes I71.20 through I71.23, I71.40 through I71.43, and I71.60 through I71.62 will offer more specificity when the resident has an aortic aneurysm without a rupture.

As we prepare to implement the new ICD-10-CM changes, there are a few things to be ready to address, says Robin Peterson, CPC, CPMA, manager of professional coding services, Pinnacle Integrated Coding Solutions LLC in Centennial, Colorado.

Review current documentation for each of the expanded categories. Are residents’ providers using documentation that supports the level of specificity necessary to report the new codes?

“You will also address the detail that is needed to support the highest level of specificity,” Peterson adds. “Also remember, the current [electronic health record] EHR templates providers are using may require updates. And lastly, any internal billing or charge systems will need to make the new codes available as of October 1, 2022.”

Consider New Codes for Chronic Ischemic Disease

You will also see the following new atherosclerosis codes under current category I25- (Chronic ischemic heart disease):

• I25.112 (Atherosclerosic heart disease of native coronary artery with refractory angina pectoris)
• I25.702 (Atherosclerosis of coronary artery bypass graft(s), unspecified, with refractory angina pectoris)
• I25.712 (Atherosclerosis of autologous vein coronary artery bypass graft(s) with refractory angina pectoris)
• I25.722 (Atherosclerosis of autologous artery coronary artery bypass graft(s) with refractory angina pectoris)
• I25.732 (Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with refractory angina pectoris)
• I25.752 (Atherosclerosis of native coronary artery of transplanted heart with refractory angina pectoris)
• I25.762 (Atherosclerosis of bypass graft of coronary artery of transplanted heart with refractory angina pectoris)
• I25.792 (Atherosclerosis of other coronary artery bypass graft(s) with refractory angina pectoris)

Don’t miss: The above codes were added because of brand-new angina pectoris code I20.2 (Refractory angina pectoris), which you will also see in 2023. Now, you will have specific combination atherosclerosis and refractory angina pectoris codes to choose from.

See New Ventricular Tachycardia Codes

You will also see the following new ventricular tachycardia codes:

• I47.20 (Ventricular tachycardia, unspecified)
• I47.21 (Torsades de pointes)
• I47.29 (Other ventricular tachycardia)

Don’t miss: Several coding notes will accompany code I47.21, including a Code also note, which specifies to also report I45.81 (Long QT syndrome), if applicable. Another coding note tells you to report an additional code for adverse effect, to identify the drug from codes T36- (Poisoning by, adverse effect of and underdosing of systemic antibiotics) through T50- (Poisoning by, adverse effect of and underdosing of diuretics and other and unspecified drugs, medicaments and biological substances), if applicable.

Highlight Dissection of Aorta Codes

You will also gain the following new dissection of aorta codes in 2023:

• I71.010 (Dissection of ascending aorta)
• I71.011 (Dissection of aortic arch)
• I71.012 (Dissection of descending thoracic aorta)
• I71.019 (Dissection of thoracic aorta, unspecified)

Don’t miss: The I71- (Aortic aneurysm and dissection) codes will get a new Code first, if applicable, note. You should first code syphilitic aortic aneurysm (A52.01) or traumatic aortic aneurysm (S25.09, S35.09), per ICD-10-CM.

Don’t Forget These Miscellaneous New Codes

ICD-10-CM 2023 also added several miscellaneous new codes including nonrheumatic valve disorder codes I34.81 (Nonrheumatic mitral (valve) annulus calcification) and I34.89 (Other nonrheumatic mitral valve disorders); pericardial effusion codes I31.31 (Malignant pericardial effusion in diseases classified elsewhere) and I31.39 (Other pericardial effusion (noninflammatory)); and antineutrophilic cytoplasmic antibody code I77.82 (Antineutrophilic cytoplasmic antibody [ANCA] vasculitis).

Don’t miss: Code I31- (Other diseases of pericardium) will also experience some coding note changes. For example, an Excludes1 note “malignant pericardial effusion (I31.31)” will be added to code I31.2 (Hemopericardium, not elsewhere classified).

Also, code I31.3 (Pericardial effusion (noninflammatory) currently includes the diagnosis chylopericardium, but that will change in 2023 when chylopericardium becomes an included diagnosis for new code I31.39.

Additionally, new code I31.31 will gain a coding note that instructs you to code first the underlying neoplasm from neoplasm categories C00- through D49-.