Otolaryngology Coding Alert

Stay afloat by getting familiar with each respective code set now. 

October 1, 2019 is just around the way, and with it comes a brand-new set of ICD-10-CM codes for otolaryngology coders to implement in their practices. Fortunately, the otolaryngology specialty, in particular, is not affected as much as other specialties — but that doesn’t mean that you can take this installment of new codes off.

In addition to some generalized new codes involving history of in-situ neoplasms and poisoning, adverse effect, and underdosing codes, there are new orbital fracture and vertigo of central origin codes that will certainly catch your attention.

Read on for a breakdown of these codes and more to get you fully prepared for when October rolls around.

Behold This Long-Awaited New Code Set

Here’s a set of specialty-specific ICD-10-CM codes for orbital wall and orbital roof fractures. For many coders, this code set has been a long time coming. “These new orbital fracture codes are very helpful,” says Kimberly Quinlan, CPC, senior medical records coder for the University of Rochester Medical Center’s Department of Otolaryngology in Rochester, New York. “When it comes to ICD-10-CM coding, the more specific, the better — so these will definitely be used,” Quinlan emphasizes.

Prior to 2020, you’ve had to resort to S02.8- (Fractures of other specified skull and facial bones) for reporting of an orbital wall or orbital roof fracture. Now, there’s a vast array of site-specific codes to utilize in the appropriate instances:

• S02.12- (Fracture of orbital roof)
• S02.83- (Fracture of medial orbital wall)
• S02.84- (Fracture of lateral orbital wall)
• S02.85X- (Fracture of orbit, unspecified).

ICD-10-CM Simplifies Vertigo of Central Origin Coding

Next up, ICD-10-CM goes for a practical approach by implementing a new, all-encompassing vertigo of central origin code:

• H81.4 (Vertigo of central origin).

ICD-10-CM will be deleting the four existing H81.4- (Vertigo of central origin) codes, presumably due to a lack of reporting.

Check Out New Poisoning, Adverse Effect, and Underdosing Codes

Continuing with a theme of practicality, new to the 2020 edition of ICD-10-CM is an updated code set for poisoning, adverse effect, and underdosing involving multiple drugs:

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

Consider Reporting for Specified Forms of Atrial Fibrillation, Pulmonary Embolism

Another important set of additions to the ICD-10-CM index involves codes for specified forms of pulmonary embolism and atrial fibrillation. While these diagnoses may not typically be listed as a chief complaint in an otolaryngology office, they may still be included in a patient’s chart. First, ICD-10-CM will delete the existing code I48.1 (Persistent atrial fibrillation) and replace it with the following codes:

• I48.11 (Longstanding persistent atrial fibrillation)
• I48.19 (Other persistent atrial fibrillation).

On a similar note, ICD-10-CM will delete existing code I48.2 (Chronic atrial fibrillation) and replace it with the following codes:

• I48.20 (Chronic atrial fibrillation, unspecified)
• I48.21 (Permanent atrial fibrillation).

You’ll also want to consider codes for reporting of single or multiple subsegmental pulmonary emboli:

• I26.93 (Single subsegmental pulmonary embolism without acute cor pulmonale)
• I26.94 (Multiple subsegmental pulmonary emboli without acute cor pulmonale).

Get Specific With Hx of In-Situ Neoplasms

Finally, familiarize yourself with a few important new personal history codes involving in-situ neoplasms:

• Z86.002 (Personal history of in-situ neoplasm of other and unspecified genital organs)
• Z86.003 (Personal history of in-situ neoplasm of oral cavity, esophagus and stomach)
• Z86.004 (Personal history of in-situ neoplasm of other and unspecified digestive organs)
• Z86.005 (Personal history of in-situ neoplasm of middle ear and respiratory system)
• Z86.006 (Personal history of melanoma in-situ)
• Z86.007 (Personal history of in-situ neoplasm of skin)