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New Additions to ICD-10-CM for Fiscal Year 2020

  • Friday, 30 August 2019 09:13
  • Written by 

The FY2020 ICD-10-CM (version 37) will come into effect October 1, 2019. Most of the changes involve adding specificity to existing FY2019 codes. For example:
Update400
     FY2019: I48.1 Persistent atrial fibrillation
              FY2020: I48.11 Longstanding persistent atrial fibrillation
              FY2020: I48.19 Other persistent atrial fibrillation
    FY2019: I48.2 Chronic atrial fibrillation
             FY2020: I48.21 Chronic atrial fibrillation, unspecified
             FY2020: I48.29 Permanent atrial fibrillation
    FY2019: D81.3 Adenosine deaminase [ADA] deficiency
              FY2020: D81.30 Adenosine deaminase deficiency, unspecified
              FY2020: D81.31 Severe combined immunodeficiency due to adenosine deaminase deficiency
              FY2020: D81.32 Adenosine deaminase 2 deficiency
              FY2020: D81.39 Other adenosine deaminase deficiency
    FY2019: R82.8 Abnormal findings on cytological and histological examination of urine
             FY2020: R82.81 Pyuria
             FY2020: R82.89 Other abnormal findings on cytological and histological examination of urine

Some sources considered the FY2019 codes I48.1 Persistent atrial fibrillation, I48.2 Chronic atrial fibrillation. D81.3 Adenosine deaminase [ADA] deficiency and R82.8 Abnormal findings on cytological and histological examination of urine to be “deleted” codes because they will not be valid for use in claims effective October 1, 2019. However, from a terminology point of view, these are considered still active “parent” codes, they are just no longer “terminal nodes”, meaning they now have “children”. They remain in the ICD-10-CM hierarchy. For example, an application may still wish to use these “parent” codes to group the “children” codes in population analysis.

Other new disease and finding codes added in FY2020 include:
      D75.A Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
      I26.93 Single subsegmental pulmonary embolism without acute cor pulmonale
      I26.94 Multiple subsegmental pulmonary emboli without acute cor pulmonale
      N99.5 Post endometrial ablation syndrome
      R11.15 Cyclical vomiting syndrome unrelated to migraine

Anatomic specificity has been added to some categories. Additional veins – peroneal vein and calf muscular vein – have been added for phlebitis and thrombosis of lower limb (under I80.2). An additional choice of overlapping quadrants is now provided for breast lumps – previously one need to specify either a single quadrant or state it as “unspecified quadrant”.

Pressure ulcer (L89) has received new codes for pressure induced deep tissue damage. For example:
     FY2019: L89.00 Pressure ulcer of unspecified elbow
             FY2019: L89.000 Pressure ulcer of unspecified elbow, unstageable
             FY2019: L89.001 Pressure ulcer of unspecified elbow, stage 1
             FY2019: L89.002 Pressure ulcer of unspecified elbow, stage 2
             FY2019: L89.003 Pressure ulcer of unspecified elbow, stage 3
             FY2019: L89.004 Pressure ulcer of unspecified elbow, stage 4
             FY2020: L89.006 Pressure-induced deep tissue damage of unspecified elbow

“Children” codes specifying laterality have been added for congenital deformities of feet (Q66), example:
     FY2019: Q66.0 Congenital talipes equinovarus
           FY2020: Q66.00 Congenital talipes equinovarus, unspecified foot
           FY2020: Q66.01 Congenital talipes equinovarus, right foot
           FY2020: Q66.02 Congenital talipes equinovarus, left foot

Specificity have also been added for congenital syndromes, as follows:
     FY2019: Q79.6 Ehlers-Danlos syndrome (note description revised to plural in FY2020, namely “Ehlers-Danlos syndromes”)
          FY2020: Q79.60 Ehlers-Danlos syndrome, unspecified
          FY2020: Q79.61 Classical Ehlers-Danlos syndrome
          FY2020: Q79.62 Hypermobile Ehlers-Danlos syndrome
          FY2020: Q79.63 Vascular Ehlers-Danlos syndrome
          FY2020: Q79.69 Other Ehlers-Danlos syndromes
    FY2019: Q87.1 Congenital malformation syndromes predominantly associated with short stature
         FY2020: Q87.11 Prader-Willi syndrome
         FY2020: Q87.19 Other congenital malformation syndromes predominantly associated with short stature

Fractures of orbital roof, medial orbital wall, lateral orbital wall and unspecified part of orbit have been added to fracture of skull and facial bones (S02). Currently, only orbital floor fracture is specified.

Currently, T50.9 Poisoning by, adverse effect of and underdosing of other and unspecified drugs, medicaments and biological substances has two “children”, T50.90 for “unspecified drugs, medicaments and biological substances” and T50.99 for “other drugs, medicaments and biological substances”. An additional subcategory T50.91 for “multiple unspecified drugs, medicaments and biological substances” have been added, with similar code hierarchy underneath it.

Heatstroke and sunstroke (T67.0) have specificity added as well, with T67.01 remaining as Heatstroke and sunstroke (implying unspecified), T67.02 being Exertional heatstroke and T67.09 being Other heatstroke and sunstroke. Example:
     FY2019: T67.0 Heatstroke and sunstroke
            FY2020: T67.01 Heatstroke and sunstroke
            FY2020: T67.01XD Heatstroke and sunstroke, subsequent encounter
            FY2020: T67.01XS Heatstroke and sunstroke, sequela

For T35 Legal intervention, currently only law enforcement official, bystander or suspect can be specified to be injured. To accommodate the situation where it is not clear who was injured, codes for “unspecified person injured” have been added to all subcategories, including for the new subcategory Y35.83 Legal intervention involving a conducted energy device, meant to accommodate use of TASER and other such means.

Encounter codes added for FY2020 include:
     Z01.02 Encounter for examination of eyes and vision following failed vision screening
          Z01.020 Encounter for examination of eyes and vision following failed vision screening without abnormal findings
          Z01.021 Encounter for examination of eyes and vision following failed vision screening with abnormal findings
     Z71.84 Encounter for health counseling related to travel

Carrier of infectious disease (Z22) has one new additional code:
     Z22.7 Latent tuberculosis

Personal history codes added are:
     Z86.002 Personal history of in-situ neoplasm of other and unspecified genital organs
     Z86.003 Personal history of in-situ neoplasm of oral cavity, esophagus and stomach
     Z86.004 Personal history of in-situ neoplasm of other and unspecified digestive organs
     Z86.005 Personal history of in-situ neoplasm of middle ear and respiratory system
     Z86.006 Personal history of in-situ neoplasm of melanoma in-situ
     Z86.007 Personal history of in-situ neoplasm of skin
     Z86.15 Personal history of latent tuberculosis infection
     Z96.82 Presence of neurostimulator

The FY2020 ICD-10-CM will be contained in the 3M HDD, together with all previous terminology versions that are concurrently available to our customers.
Please contact us if you have questions or if you’d like us to help with implementing terminologies and map sets!