Neurology & Pain Management Coding Alert

Remember that these 2020 codes take effect in 2019.

Anyone who’s played the diagnosis coding game knows that ICD-10 2020 codes go into effect on October 1, 2019, so the 2020 tag is a bit misleading.

2020 is now: The summer has delivered the usuals: scorching heat, and a new list of ICD-10 codes to consider.

No need to sweat it, though; practices will only be dealing with a single new code and some diagnosis code revisions. Plus, we’ve got the expert analysis you need to perfect these codes while it’s still baking outside. Check out what you’ll need to know to remain spot-on in your diagnosis coding with the 2020 codes.

Cyclical Vomiting Code Set Gets 1 More

There’s a single brand-new code that practices might find relevant, especially if they see migraine patients. The new code is R11.15 (Cyclical vomiting syndrome unrelated to migraine). This addition is set to give the R11.1- (Vomiting) code set another option.

So the new ICD-10 books will feature these options under R11.1- (new code in bold):

• R11.10 — Vomiting, unspecified
• R11.11 — Vomiting without nausea
• R11.12 — Projectile vomiting
• R11.13 — Vomiting of fecal matter
• R11.14 — Bilious vomiting
• R11.15.

Revisions Marked by More Vomiting, Ruptures

There are also some revisions to existing codes that you’ll want to make sure you know in order for correct coding.

The revised codes include:

• G43.A0 (Cyclical vomiting, in migraine, not intractable). In 2019, the descriptor read (Cyclical vomiting, not intractable).
• G43.A1 (Cyclical vomiting, in migraine, intractable). In 2019, the descriptor read (Cyclical vomiting, intractable).
• Z45.42 (Encounter for adjustment and management of neurostimulator). In 2019, the descriptor read (Encounter for adjustment and management of neuropacemaker (brain) (peripheral nerve) (spinal cord)).
• M50.120 (Mid-cervical disc disorder, unspecified level). ICD-10 2020 adds “level” to the end of the code descriptor.
• M66.88 (Spontaneous rupture of other tendons, other sites). ICD-10 2020 adds “sites” to the end of the code descriptor.
• M67.839 (Other specified disorders of synovium and tendon, unspecified wrist). ICD-10 2020 adds replaces  “forearm” with “wrist” in the code descriptor.

On October 1, be sure to keep these revisions in mind so you stay at the top of the heap with your diagnosis coding accuracy.

Foot Deformities Diagnoses Could Come Into Play

Another set of revisions includes the ICD-10 codes for enthesopathy affecting the foot and ankle. “The codes for congenital anomalies of the feet have been expanded for reporting of laterality,” explains Heidi Stout, BA, CPC, COSC, PCS, CCS-P, with Coder on Call, Inc., in Milltown, New Jersey.

Here’s a rundown of the revised foot/ankle codes:

• M77.5 — Other enthesopathy of foot and ankle
• M77.50 — Other enthesopathy of unspecified foot and ankle
• M77.51  — Other enthesopathy of right foot and ankle
• M77.52  — Other enthesopathy of left foot and ankle.

Revisions: In ICD-10 2019, all of the above codes ended with “foot.” Since ICD-10 2020 adds “and ankle” to all of these codes, you will be able to use them in more circumstances. 

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