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What’s new for the 2018 ICD-10-CM

 The fiscal year 2018 edition (effective October 1st, 2017) has fewer changes than the previous year’s update, but the revisions are useful and highly anticipated. Here are the highlights:

  • New codes (360)

    • You can now code four new categories of injuries: Unspecified multiple injuries, Other injury of unspecified body region, Injury unspecified, and the long-awaited code for Suicide attempt.

    • New codes are provided for the increasingly common infection: Enterocolitis due to Clostridium difficile.

    • New codes are also added for refinement within many disorders:MedRecordsStethoscope

      • Malignant mast cell neoplasms

      • Type 2 diabetes mellitus with ketoacidosis

      • Myocardial infarction

      • Pulmonary hypertension

      • Heart failure

      • Intestinal obstruction

      • Blindness and low vision

    • New categories of codes have been added for:

      • Degenerative myopia

      • Gingival recession

      • Risk for dental caries

      • Maternal care for abnormalities of the fetal heart rate or rhythm

      • Encounterfor antenatal screening of mother

      • Certain conditions originating in the perinatal period

      • Undescended and ectopic testicle

    • Many areas have expansions to 5th character for specificity:

      • Substance abuse codes for alcohol, opioids, cannabis, sedatives, cocaine, other stimulants, hallucinogens and inhalants – for thestatus of in remission

      • Header N63 unspecified lump in breast – for quadrant, axillary tail and subareolar sites

      • Header O00.1 Abdominal pregnancy – for laterality in tubal and ovarian ectopic pregnancies with intrauterine pregnancies

    • The largest addition (72 codes) is to the existing header: L97 Non-pressure chronic ulcer. It adds three new 6th character codes for: with muscle involvement without evidence of necrosis, with bone involvement without evidence of necrosis, and unspecified with other specified severity.

    • Runner up would be header V86 Occupant of special all-terrain or other off-road motor vehicle, injured in transport accident, having received two new vehicle types: 3- or 4- wheeled all-terrain vehicle (ATV) and dirt bike or motor/cross bike, for a total of 54 new codes.

  • Deleted codes (108)

    • 72 codes for illogical subsequent and sequela encounters when the patient is dead due to a brain injury in the initial encounter have been removed from Header S06 Intracranial Injury.

    • 36 codes for incorrect anatomic sites of proximal and distal interphalangeal joint codes of thumb have been removed from header S63 Dislocation and sprain of joints and ligaments at wrist and hand level – the thumb only has one interphalangeal joint

  • Existing codes with anatomic site corrections in revised descriptions (226)

    • Header S04 Injury of cranial nerve: 18 descriptions are changed from right eye to right side and left eye to left side.

    • Header S62 Fracture at wrist and hand level: 70 descriptions are changed from medial phalanx to middle phalanx of fingers.

    • Header S63 Dislocation and sprain of joints and ligaments at wrist and hand level: 18 descriptions for interphalangeal joint of thumb have the term unspecified removed.

    • Header S92 Fracture of foot and toe, except ankle: 42 descriptions are changed from medial phalanx to middle phalanx of lesser toes.


In summary, the welcomed additions and corrections of the 2018 ICD-10-CM update resulted in 21 chapters with 71,704 fully specified codes.

The 3M HDD, being a terminology server with versioning capabilities, holds, tracks and manages multiple versions of terminologies, map sets and value sets concurrently. Please contact us if you have questions or if you’d like us to help with implementing terminologies, map sets and value sets!