Oncology & Hematology Coding Alert
New in ICD-10-CM: Look For Not One But Many Changes
Proposed changes add new gastrointestinal stromal tumor and encounter codes.
In the previous issue of Oncology Coding Alert, you had a chance to peek into the extensive changes proposed for diagnosis codes for Hodgkin’s lymphoma. Added to the constellation of proposed additions and updates are codes for hepatitis carriers, encounter codes, prostatic dysplasia, and gastrointestinal stromal and caricinoid tumors. Here is a quick review of the anticipated changes.
Simplify Hepatitis Carriers by Eliminating Type
According to the new proposed changes, you will see revisions to the Z codes for carriers of viral hepatitis.
Current trends: As of now, you have to identify a ‘carrier of viral hepatitis’ by using an appropriate 5th digit expansion of Z22.5 (Carrier of viral hepatitis), depending on whether the patient is a carrier of hepatitis B, C or some other or unspecified viral hepatitis. Accordingly, you can choose from the following codes:
What you can anticipate: The proposed changes in the new set make it easier to report hepatitis carriers. You will no longer need to identify the hepatitis type. You just have to report Z22.5, irrespective of the type of hepatitis of which the patient is a carrier.
Prepare to Add Encounter Codes
According to proposed changes, you can add the following ‘encounter’ codes to your current lists:
Look at Histology for Prostatic Dysplasia
ICD-10-CM 2017 adds specificity for prostate dysplasia by deleting N42.3 (Dysplasia of prostate) and replacing it with the following more specific codes:
“The expansion would aid in tracking the types of dysplasia of the prostate allowing more specific tracking of types/cause/severity/progression and evolving treatment guideline limitations,” says Kelly C. Loya, CPC-I, CHC, CPhT, CRMA, Managing Director of Pinnacle Enterprise Risk Consulting Services (“PERCS”), a division of Pinnacle Healthcare Consulting.
Find Revisions and New Codes for GI Tumors
In ICD-10-CM 2017, you may find the following new codes describing gastrointestinal stromal tumors. You will choose the appropriate code depending upon the anatomical location of the stromal tumor in the gastrointestinal tract. They are:
Additionally, mark the revisions below for descriptors of the malignant carcinoid codes:
Currently, the descriptor for C7A.094 reads ‘Malignant carcinoid tumor of the foregut NOS.’ In 2017, ‘NOS’ is substituted with ‘unspecified.’ The new code descriptor for C7A.094 will hence read ‘Malignant carcinoid tumor of the foregut, unspecified.’
Similarly, the new code descriptors for C7A.095 and C7A.096 are the following:
“The specific location of the cancer is usually known and documented by providers but sometimes a specific ICD-10-CM diagnosis code does not exist and providers are forced to use an ‘unspecified’ code. These new diagnosis codes will allow providers to choose a diagnosis that matches their documentation,” says Janae Ballard, CPC, COC, CPMA, CEMC, Manager, Professional Audit Services, Altegra Health, Los Angeles, CA.
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