In our continuing series on the 2018 changes to the ICD-10 codes, we will cover the updates that occurred in chapters 6-8. As you will learn, some chapters were more heavily impacted than others; nonetheless your staff must be aware of all these key changes.
Chapter 6 – Diseases of the Nervous System
When discussing the nervous system, you must consider the central nervous system as well as the peripheral nervous system. Chapter 6 includes codes for degenerative nerve disorders, congenital disorders, movement disorders, muscle disorders, post/intraoperative disorders and pain not coded elsewhere. Many codes covered in this chapter are related to conditions coded in other chapters and require multiple codes.
Below are three new codes dealing with diseases of the nervous system:
Primary lateral sclerosis, similar to ALS but progression is slower and is usually not fatal.
Familial motor neuron disease is in a gene mutation and usually another person in the family will have the same condition.
Progressive spinal muscle atrophy, another genetic disorder that affects muscle movement. It is caused by the loss of motor neurons in the spinal cord and brainstem.
Chapter 7 – Diseases of the Eye and Adnexa
Chapter 7 was more heavily impacted by the 2018 ICD-10 coding changes with 55 new codes.
Twenty of the 55 codes are new and relate to specific types of degenerative myopia.
Nine of the 55 codes further specify blindness in both eyes. The H54 codes are used specifically for eye conditions such as cataracts, retinopathy, glaucoma, hemianopsia and others. These conditions should be coded first. Note – legal blindness in the USA uses the H54.8 code, not the H54.0 codes.
Also, new H54 codes for blindness, follow the coding guidelines below to determine the seventh character for vision relating to the eye not included in the code:
If “blindness” or “low vision” of both eyes is documented but the visual impairment category is not documented, assign code H54.3 – Unqualified visual loss, both eyes. If “blindness” or “low vision” in one eye is documented but the visual impairment category is not documented, assign a code from H54.6 – Unqualified visual loss, one eye. If “blindness” or “visual loss” is documented without any information about whether one or both eyes are affected, assign code H54.7 – Unspecified visual loss.
Chapter 8 – Diseases of the Ear and Mastoid Process
In this round of ICD-10 updates there were no changes to Chapter 8. However, it is key to note that hearing loss is coded to H90. The H90 code specifically includes:
- Conductive and sensorineural hearing loss (largest sub-category of hearing loss codes)
- Ototoxic hearing loss
- Sudden idiopathic hearing loss
- Other hearing loss
- Unspecified hearing loss
Our Team Stands Out from the Competition
2018 brought many ICD-10 coding changes to the industry. 5 Star can help ensure not only that your staff is trained on the latest industry updates, but your coding can even be outsourced to our knowledgeable team. The 5 Star team is comprised of highly skilled, certified RN coders. We can manage all your coding needs by working with your clinicians to ensure accuracy, clinical compliance and optimized reimbursement for your agency. For further information about our coding services, training, or manuals/DVDs, please contact us at [email protected] or 866-428-4040.