Final FY 2020 ICD-10-CM changes include hundreds of new tabular instructions

The CDC has posted the FY2020 ICD-CM final code changes, and there were no changes to the proposed list of 273 new, 30 revised and 21 invalidated codes that were released in the proposed inpatient hospital prospective payment system rule, April 23. 

However, the tabular addendum shows that your practice and your payers will have to understand and incorporate considerably more coding instructions in 102 days.

Coders will have new ICD-10-CM codes to report pressure-induced deep tissue damage, acute versus chronic embolism and thrombosis and fractures of the facial bones around the eye, among other changes.

In addition, you’ll be able to report conditions such as eating disorders of nonorganic origin (F50.-) and malnutrition (E40-E46) with codes from the symptoms and signs concerning food and fluid intake family (R63) effective Oct. 1. In addition, it may be appropriate to report traumatic ischemic infarction of muscle (T79.6) with traumatic compartment syndrome, and when the patient’s diagnosis is respiratory syncytial virus as the cause of diseases classified elsewhere (B97.4), you’ll code a related disorder such as otitis media (H65.-) or upper respiratory infection (J06.9) first.

That’s a high-level look at the hundreds of changes to the tabular instructions for ICD-10-CM FY2020. The Centers for Disease Control (CDC) released 23 files for the final FY2020 ICD-10-CM code set.

Here are some more changes you’ll find in the tabular notes throughout the manual:

• Chapter 2, Neoplasms (C00-D-49): Polyp of colon NOS (K63.5), will be an excludes 1 code for all codes in the benign neoplasm of colon, rectum, anus and anal canal (D12) family. Currently it is an excludes 1 code for unspecified benign neoplasm of the colon (D12.6). A clarifying term for benign neoplasm of connective and other soft tissue of trunk, unspecified (D21.6) has been revised from “benign neoplasm of back NOS” to “benign neoplasm of connective and other soft tissue back NOS.”

• Chapter 3, Diseases of the blood and blood-forming organs and certain disorders involving the immunemechanism (D50-D89): You’ll find clarifying terms and notes for the four new adenosine deaminase [ADA] deficiency codes (D81.30-D81.39) that will replace adenosine deaminase [ADA] deficiency (D81.3). For example, the clarifying terms for D81.31 (Severe combined immunodeficiency due to adenosine deaminase) are “ADA deficiency with SCID” and “Adenosine deaminase [ADA] deficiency with severe combined immunodeficiency.”

• Chapter 6, Diseases of the nervous system (G00-G990: You will not be able to report the new code for cyclical vomiting unrelated to migraine (R11.15) with any cyclical vomiting codes (G43.A), a new excludes 1 note states. In addition, rheumatoid polyneuropathy with rheumatoid arthritis codes (M05.5-) will replace rheumatoid arthritis (M05.33) in the excludes 1 notes for the polyneuropathy in diseases classified elsewhere family (G63).

Editor's note: This article was originally published by DecisionHealth. 

View the full list of updates at https://bit.ly/2J3lHvJ. View the tabular addenda at https://bit.ly/2WWdgHe.