Radiology Coding Alert

ICD-10-CM 2022:

Traumatic Brain Compression, Gastric Intestinal Metaplasia Diagnoses Highlight New Radiology Coding Options

Published on Mon Jul 19, 2021

Pay attention to how you’ll need to expand your cough diagnoses.

The Centers for Disease Control (CDC) has released the 2022 ICD-10-CM codes that take effect October 1, 2021, which means you and your radiology practice should take note. You’ll find a variety of new and converted codes that apply to your specialty.

Radiology coders have come to expect an annual delivery of specialty-specific codes, but that isn’t the case this year. “There aren’t any specific codes that apply to radiology, as this specialty can cover everything on the body from head to toe,” says Kristen Taylor, CPC, CHC, CHIAP, Associate Partner at Pinnacle Enterprise Risk Consulting Services in Columbia, South Carolina. Several codes apply to radiology due to the procedures performed by radiologists regularly, Taylor adds.

Read on to dive into the new or converted ICD-10-CM codes for the upcoming year.

You’ll Need to Specify Diagnoses with Converted Parent Codes

You’ll find several ICD-10-CM codes in the 2022 manual that have been converted to parent codes. “It appears these codes were converted to parents to help increase specificity. For example, the M54.5 (Low back pain) may be used to perform a spine study,” says Taylor.

Two 2022 ICD-10-CM codes that apply to radiology include:

M54.5 (Low back pain)
R05 (Cough)

In the case of low back pain, you’ll have more specific codes M54.50 (Low back pain, unspecified), M54.51 (Vertebrogenic low back pain), and M54.59 (Other low back pain). So, if a radiologist performs a spine study on a patient who specifically has vertebrogenic low back pain, you’ll be able to submit M54.51 after October 1.

In the case of cough, you’ll have six new expanded codes:

R05.1 (Acute cough)
R05.2 (Subacute cough)
R05.3 (Chronic cough)
R05.4 (Cough syncope)
R05.8 (Other specified cough)
R05.9 (Cough, unspecified)

The codes now give you more specificity for this common symptom, giving you the choice of three levels of severity, from acute through subacute to chronic, the last of which also has three synonyms: persistent cough, refractory cough, and unexplained cough. For instance, you will be able to use R05.4 to document cough syncope, a condition where a patient loses consciousness after a coughing bout.

Check for New COVID-19 Codes When Recording Chest X-rays

In the United States, the chance of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19, has been diminished due to so many people receiving the COVID-19 vaccine, but that doesn’t mean the effects of the coronavirus are over. Many patients may experience long-haul symptoms that medical experts will be tracking and studying for years to come. The ICD-10-CM manual has added two new COVID-19 codes for documentation — U09 (Post COVID-19 condition) and U09.9 (…, unspecified).

New Traumatic Brain Compression Code Set

Another new code set for 2022 involves a set of traumatic brain compression codes with and without herniation. As the codes would pertain to a head injury, radiologists could use them when performing X-rays, MRIs, CT scans, and other procedures to diagnose the patient’s condition.

Prior to the addition of the new S06.- code set, you would use G93.5 (Compression of brain) to document the condition. However, ICD-10-CM lists diffuse traumatic compression of brain (S06.2-) and focal traumatic compression of brain (S06.3-) as Excludes1 codes for G93.5.

As of October 1, you will find a large assortment of traumatic brain compression codes to use in applicable instances:

S06.A (Traumatic brain compression and herniation)
S06.A0 (Traumatic brain compression without herniation)
S06.A0XA (Traumatic brain compression without herniation, initial encounter)
S06.A0XD (…, subsequent encounter)
S06.A0XS (…, sequela)
S06.A1 (Traumatic brain compression with herniation)
S06.A1XA (…, initial encounter)
S06.A1XD (…, subsequent encounter)
S06.A1XS (…, sequela)

Note: With the S06.A0- and S06.A1- code sets, you will need that 7th character to indicate initial or subsequent encounters or sequela. Make sure to check the documentation for this information or consult the radiologist for the missing information.

Add This Gastro Code Set for 2022

New to the 2022 ICD-10-CM code index is a set of codes related to gastric intestinal metaplasia with or without dysplasia. These codes may be used by a radiologist if a physician orders a procedure for intestinal studies. Additionally, some of the K31.- codes will require a 6th character to help further specify the diagnosis.