Pathology/Lab Coding Alert
Get Ready for 2024 Dx Codes Relevant to Your Lab
Plan to implement the changes on Oct. 1 Nearly 400 ICD-10-CM code additions as well as many deletions and revisions could impact your diagnosis coding when the latest update goes into effect on Oct. 1. We’re here to help you focus on the changes you need to know for your clinical lab or pathology practice. Recall: Pathologists often assign diagnosis codes based on findings from procedures such as tissue exams, and clinical labs must use current ICD-10-CM codes assigned by the ordering physician to demonstrate medical necessity for ordered tests. Bonus: Medicare quality reporting programs also rely on appropriate diagnosis coding to evaluate appropriate procedures — so missing the boat now could impact your bottom line later. See Microbiology-Related Changes The ICD-10-CM update adds the following new codes you need to be aware of in your microbiology lab: Clinicians may use these codes based on clinical factors and lab test results that identify the microorganism involved in the pathology. You’ll also find the following new codes that identify carriers of specified bacterial infections: Update Pathologic Fracture Coding Beginning Oct. 1, you’ll have new, more specific codes for reporting a pathologic fracture of the pelvis, as follows: Analysis: These codes add further anatomical specificity to the pathological fracture ICD-10-CM codes. Previously, there was no way to specify that the fracture was to the patient’s pelvis. Definition: Remember, a pathological fracture is a type of fracture that occurs in a bone that has been weakened by an underlying disease or condition. It is different from a typical fracture that occurs due to trauma or injury. In a pathological fracture, the bone breaks more easily because it has been compromised by an existing condition, such as osteoporosis or a tumor. “Pathologists should be aware of the need to identify the laterality of the fracture when they examine and diagnose a bone specimen using a code such as 88307 (Level V - Surgical pathology, gross and microscopic examination … Bone fragment[s], pathologic fracture …),” says R.M. Stainton Jr., MD, president of Doctors’ Anatomic Pathology Services in Jonesboro, Arkansas. 7th character alert: Clinicians should provide the details to allow reporting these codes to the 7th character using one of these options: New Dx Codes May Link to Molecular Tests If your lab does molecular testing, you might see some of the following new 2024 diagnosis codes for metabolic, congenital, or other disorders on orders for specific lab tests. Note: ICD-10-CM converts G20 (Parkinson’s disease) to a parent code for the following, more specific new codes: Analysis: With all the disease variability, G20 was the only code for Parkinson’s disease in the ICD-10-CM code book before 2024. These updates will make Parkinson’s coding more specific by adding information about dyskinesia and fluctuations. “Greater specificity in Parkinson’s disease is helpful in tracking treatments of this condition. Given that Parkinson’s disease has several manifestations in a patient’s condition and function, greater granularity in the diagnosis codes will help track how the various manifestations of Parkinson’s disease responds to various treatments,” says Gregory Przybylski, MD, Chairman of Neuroscience at the New Jersey Neuroscience Institute, JFK University Medical Center in Edison, New Jersey. Any expansion of the Parkinson’s codes is a positive, he adds. A lab test such as 0393U (Neurology (eg, Parkinson disease, dementia with Lewy bodies), cerebrospinal fluid (CSF), detection of misfolded α-synuclein protein by seed amplification assay, qualitative) may aid in the early diagnosis of Parkinson’s disease in symptomatic patients. Greet New Desmoid Tumor Codes Another new group of codes for 2024 describes desmoid tumors, which are rare lesions that may afflict various parts of the human anatomy. Desmoid tumors develop in the connective tissue, which is the tissue that supports and connects various structures in the body. These tumors can occur anywhere in the body, but they most commonly develop in the abdominal wall, shoulder, or thigh. Prior to the addition of these codes, you might have reported a desmoid tumor using D48.1 (Neoplasm of uncertain behavior of connective and other soft tissue). When your pathologist identifies one of these tumors, you should take note of these new codes when ICD-10-CM 2024 takes effect Oct. 1: Capture Detailed History of Colon Polyp ICD-10-CM 2024 extends the Z83.71 (Family history of colonic polyps) family for greater specificity with the following codes: Clinicians may report these codes to show medical necessity for colonoscopy and possible biopsy that occurs more frequently than screening coverage rules allow.
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