Medicare Compliance & Reimbursement

Do you know what KCNQ2-related epilepsy is?

ICD-10 just settled on its list of new, revised, and deleted codes for 2025, and it has several additions that will be relevant to your practice if it sees patients with epilepsy or spinal issues.

Do this: Get used to these codes before you have to start using them by looking at them early. Remember, you are supposed to use the 2025 ICD-10 code list on October 1, 2024.

Check out some of the codes that could affect your coding come October.

ICD-10 Reveals New Epilepsy Group

There will be a whole new set of epilepsy codes in the G40.8- (Other encephalitis, myelitis and encephalomyelitis) section of ICD-10. The new codes are:

• G40.84 (KCNQ2-related epilepsy)
• G40.841 (KCNQ2-related epilepsy, not intractable, with status epilepticus)
• G40.842 (KCNQ2-related epilepsy, not intractable, without status epilepticus)
• G40.843 (KCNQ2-related epilepsy, intractable, with status epilepticus)
• G40.844 (KCNQ2-related epilepsy, intractable, without status epilepticus)

Condition description: KCNQ2-related epilepsy results from mutations in the KCNQ2 gene, which regulates neuronal excitability. This condition is able to manifest itself as various epilepsy types. Symptoms of KCNQ-2-related epilepsy include developmental delays, intellectual disability, and movement disorders.

Several Codes Converted to Parents

There are also several ICD-10 codes that were converted to “parent” codes, and will spawn new codes that are under the parent code’s heading.

Example: One of the codes that ICD-10 converted to parent was G90.8 (Other disorders of autonomic nervous system). Starting on October 1, the code will expand to require a 5th character (G90.8-). The new codes beneath G90.8- (the “children”) are:

• G90.81 (Serotonin syndrome)
• G90.89 (Other disorders of autonomic nervous system)

Impact: This move gives a specific ICD-10 code to serotonin syndrome, which you would code as G90.8 currently.

The next code that will covert to parent in October is M51.36 (Other intervertebral disc degeneration, lumbar region). When the code becomes M51.36-, these will be your 6th character options:

• M51.360 (Other intervertebral disc degeneration, lumbar region with discogenic back pain only)
• M51.361 (Other intervertebral disc degeneration, lumbar region with lower extremity pain only)
• M51.362 (Other intervertebral disc degeneration, lumbar region with discogenic back pain and lower extremity pain)
• M51.369 (Other intervertebral disc degeneration, lumbar region without mention of lumbar back pain or lower extremity pain)

Impact: This move will make M51.36 a code set that includes descriptions indicating the absence/presence of lower extremity pain, discogenic back pain, and lumbar back pain.

Finally, ICD-10 also converted M51.37 (Other intervertebral disc degeneration, lumbosacral region) to parent for 2025.

When this code starts requiring a 6th character, these will be your options:

• M51.370 (Other intervertebral disc degeneration, lumbosacral region with discogenic back pain only)
• M51.371 (Other intervertebral disc degeneration, lumbosacral region with lower extremity pain only)
• M51.372 (Other intervertebral disc degeneration, lumbosacral region with discogenic back pain and lower extremity pain)
• M51.379 (Other intervertebral disc degeneration, lumbosacral region without mention of lumbar back pain or lower extremity pain)

Impact: Much like M51.36, the expansion of M51.37 will result in a code set that includes descriptions indicating the absence/presence of lower extremity pain, discogenic back pain, and lumbar back pain.

Remember to Note These Standalone Codes

There are also a pair of new codes don’t come in a group, as the ones above do. These codes are:

• G93.45 (Developmental and epileptic encephalopathy)
• M62.85 (Dysfunction of the multifidus muscles, lumbar region).

Chris Boucher, MS, CPC, Senior Development Editor, AAPC