Since 2015 ICD-10 has been keeping the home health industry busy with coding changes. If you have been reading our blog series regarding 2018 ICD-10 code updates, it may seem a bit overwhelming. However, this is our last blog in this series, and it will cover any of the remaining new, revised or deleted codes that are part of the overall 728 code updates, which were ushered in fiscal 2018.
Diseases of the Skin and Subcutaneous Tissue
Chapter 12 covers diseases of the skin and subcutaneous tissue. These diseases are covered by codes L00-L99. This chapter alone includes 72 new codes just to specify the severity of a non-pressure chronic ulcer of the lower extremity. A few examples of these new codes include:
L97.318 Non‐pressure chronic ulcer of right ankle with muscle involvement with other specified severity
L97.326 Non‐pressure chronic ulcer of left ankle with bone involvement without evidence of necrosis
L97.925 Non‐pressure chronic ulcer of unspecified part of left lower leg with muscle involvement with evidence of necrosis
If you do not know the etiology or cause of the ulcer you should try to determine as auditors whether you are looking for two codes with the L97 codes. If the cause of the ulcer is known, then it should be coded first. Any gangrene associated with an ulcer should also be coded first.
Key Points Related to Diseases of the Musculoskeletal System and Connective Tissue
Chapter 13 or codes M00-M99 cover diseases related to the musculoskeletal system and connective tissue. We will just review some of the high-level changes from this chapter. First, most of the codes within Chapter 13 have site and laterality designations. The site represents the bone, joint or muscle involved. If more than one bone, joint or muscle is involved, there are “multiple sites” codes, which should be used. Next, the M80 code is used to code a pathological fracture or insufficiency fracture, which is a bone fracture caused by a disease, such as osteoporosis, that resulted in weakness in the bone structure. The M81 code should be used for osteoporosis without a current fracture. Finally, age related osteoporosis is the default if the type of osteoporosis is not documented.
The Last ICD-10 Code Changes – Chapter 18
Chapter 18 deals with symptoms, signs, and abnormal clinical and laboratory findings that are not classified anywhere else. They are designated by codes R00-R99. Below are a few examples of these codes and what they cover:
R06.03 Acute respiratory distress – a new code
Note: Do not assign a R06 code with a code for COPD, bronchitis, asthma or any other condition that would cause respiratory distress.
R29.6 Repeated falls – Only use when the reason for the fall is unknown or is under investigation. Z91.81 is used for a history of falls and for the risk of future falls. We are mentioning this code is because it can be used in conjunction with R29.6 when appropriate (i.e. if the cause of the fall is not known and the patient is still at risk of falling).
2018 ICD-10 Coding Changes Made Simple
Yes, 2018 ICD-10 coding changes can be made simple thanks to our knowledgeable 5 Star team. Our highly skilled certified RN coders can become your outsourced coding department or can assist your staff to ensure maximum reimbursement is achieved.
If you would like to learn more about our training options and/or other educational materials we offer, please feel free to contact us at [email protected] or 866-428-4040.