Radiology Coding Alert
Start Prep Now for these New and Revised Radiological ICD-10-CM Codes
Employ these crucial codes into your radiology coding repertoire in time for 2019. Staying on top of the vast number of new and revised ICD-10 codes arriving in October should always be a priority for radiology coders. Depending on your years of expertise, you may be used to the extensive number of new codes that affect the radiology specialty. You’ll find that this year is no different. “As in years past, 2019 will see a significant number of ICD-10 code changes,” says Amanda Corney, MBA, medical billing operations manager for Medical Resources Management in Rochester, New York. “On October 1st, 2018 you need to be ready to incorporate both new and revised codes — as well as suspend the use of a select group of deleted codes,” Corney relays. Keep reading for a first look at some of the most pertinent new ICD-10-CM codes for the radiology specialty. Disclaimer: The following list of codes only encompasses a portion of a much larger list of new ICD-10-CM codes. You can find the complete list here: www.cms.gov/Medicare/Coding/ICD10/2019-ICD-10-CM.html. Get to Know Codes for Hereditary Cerebrovascular Disease, Small Artery Infarction This first new set of cerebrovascular-specific ICD-10 is certain to have an impact on the radiology specialty: Currently, ICD-10 offers cerebral infarction codes due to occlusion and stenosis of the precerebral, vertebral, carotid, cerebral, and cerebellar arteries. Starting Oct. 1, you’ll have the option of coding for a small artery cerebral infarction, when applicable. ICD-10 will also incorporate a new set of hereditary cerebrovascular diseases codes (I67.85-). Specifically, you’ll report I67.850 for a rare disease of the blood vessels known as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). You will also have the option of coding any other specified hereditary cerebrovascular diseases using I67.858. Finally, ICD-10 will convert I63.8 (Other cerebral infarction) to I63.89. Be Specific with Acute Appendicitis Codes Next up is a new set of appendicitis with peritonitis combination codes: Previously, you could only report appendicitis with generalized or localized peritonitis. You now have the option of adding a new set of additional, complicating diagnoses. “The new appendicitis codes allow us to distinguish between different degrees of appendicitis, each of which carries a different level of morbidity and risk for mortality,” says Sheri Poe Bernard, CPC, of Poe Bernard Consulting in Salt Lake City, Utah. “These new codes specify presence of gangrene and/or perforation, local or generalized peritonitis, or presence of abscess,” Bernard relays. Focus on Gastroenterological Code Additions Alongside the new acute appendicitis with peritonitis codes come five important gastroenterological additions: First, ICD-10 has incorporated new codes for anorectal supralevator and horseshoe abscesses. You’ll also be introduced to a new set of gallbladder disorder codes. You will use the K82.A- code set to report gangrene or perforation of the gallbladder in a patient with a cholecystitis diagnosis. Lastly, you’ll want to incorporate code K83.01 for reporting primary sclerosing cholangitis. Take Note of New Triplet, Quadruplet Code Sets Next up you’ll find a brand-new set of obstetrical codes focused on identifying trichorionic/triamniotic triplet pregnancies and quadrachorionic/quadra-amniotic quadruplet pregnancies: As you can see, you now have the option to code triplet, quadruplet, and other multiple gestation pregnancies when the number of chorions and amnions are both equal to the number of fetuses. For multiple gestation pregnancies in which the number of chorions and amnions does not equal the number of fetuses, refer back to the existing code set. Make Way for these Important New Abnormal Radiologic Findings Codes Last, but certainly not least, is a set of four new abnormal urological imaging codes: You may find this new set of urology codes useful alternatives to a code such as N50.9 (Disorder of male genital organs, unspecified). However, as is the case with all “abnormal findings” codes, be careful to only use them in the appropriate setting. Specifically, you should let the wording of the dictation report lead you to the most appropriate code. For example, If the provider documents a clear and present (non-indexable) finding of the testicles, without alluding to a specific condition, then opt for N50.9. If the provider instead documents one or more ambiguous findings, and the index doesn’t lead you to a definitive condition code, then resort to the R93.81- code set.
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