Urology Coding Alert

Hint: Pay attention to “Code also notes.”

The Centers for Medicare & Medicaid Services (CMS) recently released the new ICD-10-CM 2023 codes. Not only will you gain some new nephropathy codes, but you will also see new Z codes, external cause codes, and endometriosis of the bladder and ureter options.

Learn more about how to prep your urology practice for these codes, which will go into effect Oct. 1, 2022.

Focus on 2 New Nephropathy Codes

In 2023, you will gain a couple of new nephropathy codes. For example, you will see new code N14.11 (Contrast-induced nephropathy). Code N14.11 will also include contrast medium, radiography nephropathy. You will also get a new Excludes2 note for N14.11 “acute kidney failure (N17.-).”

You will also see new code N14.19 (Nephropathy induced by other drugs, medicaments and biological substances) in 2023.

Nephropathy defined: Nephropathy is disease or damage of the kidneys, which can result in kidney failure.

Pinpoint New Endometriosis of Bladder and Ureter Options

In 2023, you will also see new category N80.A- (Endometriosis of bladder and ureters). New codes in that category include the following:

• N80.A0 (Endometriosis of bladder, unspecified depth). Note: This code will also include endometriosis of the bladder NOS.
• N80.A1 (Superficial endometriosis of bladder)
• N80.A2 (Deep endometriosis of bladder)
• N80.A41 (Superficial endometriosis of right ureter)
• N80.A42 (Superficial endometriosis of left ureter)
• N80.A43 (Superficial endometriosis of bilateral ureters)
• N80.A49 (Superficial endometriosis of unspecified ureter)
• N80.A51 (Deep endometriosis of right ureter)
• N80.A52 (Deep endometriosis of left ureter)
• N80.A53 (Deep endometriosis of bilateral ureters)
• N80.A59 (Deep endometriosis of unspecified ureter)
• N80.A61 (Endometriosis of ureter, unspecified depth)
• N80.A62 (Endometriosis of left ureter, unspecified depth)
• N80.A63 (Endometriosis of bilateral ureters, unspecified depth)
• N80.A69 (Endometriosis of unspecif ied ureter, unspecified depth)

Don’t miss: All of the above codes will gain a new Code also note that instructs you to also report obstructive and reflux uropathy (N13.-), if applicable.

Mark Down New Z Options

You will see numerous new Z codes in 2023, including but not limited to the following:

• Z59.82 (Transportation insecurity). Note: This code will include excessive transportation time, inaccessible transportation, inadequate transportation, lack of transportation, unaffordable transportation, unreliable transportation, and unsafe transportation.
• Z59.86 (Financial insecurity). Note: This code will also include bankruptcy, burdensome debt, economic strain, financial strain. money problems, running out of money, and unable to make ends meet.
• Z59.87 (Material hardship). Note: This code will also include material deprivation, unable to obtain adequate childcare, unable to obtain adequate clothing, unable to obtain adequate utilities, and unable to obtain basic needs.
• Z91.19- (Patient’s noncompliance with other medical treatment and regimen)
• Z91.A- (Caregiver’s noncompliance with patient’s medical treatment and regimen)
• Z91.A2- (Caregiver’s intentional underdosing of patient’s medication regimen)
• Z91.A3 (Caregiver’s unintentional underdosing of patient’s medication regimen)
• Z91.A4 (Caregiver’s other noncompliance with patient’s medication regimen)
• Z91.A5 (Caregiver’s noncompliance with patient’s renal dialysis)
• Z91.A9 (Caregiver’s noncompliance with patient’s other medical treatment and regimen)

Don’t miss: You will report Z codes, Z00- (Encounter for general examination without complaint, suspected or reported diagnosis) through Z99- (Dependence on enabling machines and devices, not elsewhere classified) for factors influencing health status and contact with health services. Z codes represent reasons for encounters.

Don’t Miss These Brand-New External Cause Codes

You will also see many new external cause codes in 2023, including but not limited to the following:

• V20.01 (Electric (assisted) bicycle driver injured in collision with pedestrian or animal in nontraffic accident)
• V21.01 (Electric (assisted) bicycle driver injured in collision with pedal cycle in nontraffic accident)
• V22.31 (Person boarding or alighting an electric (assisted) bicycle injured in collision with two- or three-wheeled motor vehicle)
• V23.41 (Electric (assisted) bicycle driver injured in collision with car, pick-up truck or van in traffic accident)
• V27.11 (Electric (assisted) bicycle passenger injured in collision with fixed or stationary object in nontraffic accident)

Coding tip: Although not nationally mandated, external cause codes V00- (Pedestrian conveyance accident) through Y99- (External cause status) can and should be used on your claims, when applicable.

There are no national requirements that mandate you to report external cause codes. However, providers are still encouraged to voluntarily report these codes because they “provide valuable data for injury research and evaluation of injury prevention strategies,” per the ICD-10-CM Official Guidelines for Coding and Reporting. Although external cause codes are not payment codes, they can add important supplemental information to your claims.

“Many of the above ICD-10-CM codes will rarely be used in urology coding and for reimbursement but will add to the accuracy of the clinical scenarios as requested by many carriers,” says Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology, State University of New York, Stony Brook. “Add the above ICD-10-CM codes to your diagnostic list for possible use in the future.”