Urology Coding Alert
Details Make the Difference in Urinary Stent Diagnoses
Here’s your second look at how familiar codes will change in October.
The time until the new ICD-10 updates go into effect is counting down, with October 1 as the official implementation date. Last month we looked at how your diagnoses for some catheter, hemorrhage, and diagnostic imaging will change. Now we’ll dig into what will change for urinary stents and urinary sphincter implants.
Pay Attention to Small Details for Urinary Stents
When you need to report a breakdown or displacement of a urinary stent, a few descriptors will change only a couple of words. For example, T83.112A will change from “Breakdown (mechanical) of urinary stent, initial encounter” to “Breakdown (mechanical) of indwelling ureteral stent, initial encounter.”
The same changes will apply to the subsequent encounter and sequela options.
“This change indicates that these stents are indwelling, the definition given to the double J or double pigtail type stents,” explains Michael A. Ferragamo, MD, FACS, clinical assistant professor at the State University of New York at Stony Brook. “These stents remain within the ureter for a specific period of time postoperatively to drain the system and allow passage of urinary gravel and small calculi.”
Once you’re accustomed to that change, it will also apply to the code families for displacement and other mechanical complications of urinary stents. The new base codes for these groups will be:
A new option will also be added to each of these code families, with seventh character specifications of initial encounter, subsequent encounter, or sequela. The base codes are:
“This change indicates the non-indwelling catheters such as whistle tipped or olive tipped ureteral catheters which are placed prior to surgery and removed immediately after surgery is completed,” Ferragamo explains.
Follow the Same Pattern for Urinary Sphincter Implants
Diagnoses for mechanical breakdown, displacement, and other mechanical complications of urinary sphincter implants will see the same changes as the urinary stents. The descriptor wording will change from “urinary sphincter implant” to “implanted urinary sphincter.”
Each code group will have three options to designate initial or subsequent encounter or sequela:
This change emphasizes that these sphincters have been surgically implanted.
Add New Options for Graft and Mesh Erosion
While many of the urology-related changes are minor revisions, you will have some new code choices that will allow you to report conditions with more specificity. Each diagnosis will have three variations to indicate the encounter status.
Be careful: Note that the only difference between the codes from T83.713~ and T83.714~ is a single word: urethral versus ureteral. Pay close attention to your provider’s documentation and whether he is referring to the patient’s ureter or urethra.
Anytime a patient has a mesh implant or bulking agent injection, there’s a chance of complications including erosion into neighboring structures. ICD-10’s proposed updates will include three new code groups for these situations:
Good change: The addition of revised and new ICD-10 codes allows one to document increased specificity of a particular clinical scenario.
Don’t Miss These Miscellaneous Changes
When you’re studying numerous groups of codes with widespread changes, it can be easy to miss updates that only include two or three codes. Don’t let that happen with these revisions and deletions:
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