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Stay in Compliance with 2018 ICD-10-CM Updates

Mon, Jul. 31, 2017 Posted: 03:58 AM

Are you finding it hard to keep up with the pressure of annual code updates?

Your practice faces 845 + ICD-10-CM changes, including 454 additions, 142 deletions, and 250+ revisions that could impact how you code your cases. And the challenges coming your way involve more changes than originally proposed.

In this article, we unpack the key additions and revisions for your specialty:

Cardiology and Vascular Surger

Important changes for cardiology include new codes for myocardial infarction, including a new specific option for type 2 (I21.A1). You’ll also find new codes accommodating types of right heart failure, such as acute (I50.811), chronic (I50.812), acute on chronic (I50.813) and unspecified (I50.810). Pulmonary hypertension code choices also expand under I27.2- that allow you to better define cause. Additionally, there are some easy-to-miss changes for cerebral infarction, embolism and thrombosis, and varicose veins.


Eye coders will have plenty of updates to take care of. Some of the changes are as simple as spelling correction, but you’ll find numerous changes that will have a real impact on your coding. You’ll have dozens of new ICD-10-CM codes in the degenerative myopia (H44.2) category, now requiring you to have very specific information about the type of myopia. And the good news for eye care coders is that ICD-10 now includes codes for bilateral blindness of different categories.


Gastroenterology coders will find more specific code choices for intestinal adhesions and obstruction. You’ll need to know whether obstructions are partial or complete to avoid mistakes. Note that the intestinal obstruction codes go out to six characters, while for the new intestinal adhesion codes, you’re require to report just five characters. You’ll also find plenty of options for non-pressure chronic ulcer to help you report cases without evidence of necrosis.

Neurology & Pain Management

While neurology and pain management coders will have to keep up with many new codes, most changes are more subtle. Many of the descriptors for existing codes will expand for greater specificity. You’ll find a lot more detail in the code set F10-F19 — both in the form of expanded descriptors and new codes. You will be able to more accurately locate the stage of the patient’s substance abuse and recovery thanks to the 9 new codes.

Primary lateral sclerosis now has its own code, and the motor neuron disease will get more specific with the addition of some new diagnoses in the G12.2 code set


For orthopedics, a few minor changes will lead to a whole lot of updates, such as the code descriptors for metacarpal fracture (S62.3-) the period in the middle will be changed to a comma, while Phalanx fracture codes for the finger and toe will see a swap in language from “medial phalanx” to “middle phalanx.”


If you code for women’s health, watch out for changes to reporting of an unspecified lump in the breast under N63, expansion of tubal and ovarian pregnancy codes that allow you to identify the side affected, among other changes. Antenatal screening encounter codes also get a makeover with 17 new codes to expand reporting options of screening tests to determine fetal growth retardation and chromosomal abnormalities.

Round Up the Latest 2018 ICD-10-CM Changes for a Denial-Free Start Oct. 1

You have little time to prepare for these ICD-10-CM code changes. But you can get up to speed with TCI’s one-stop ICD-10 coding resources, jam-packed with new and revised codes and their descriptors, along with official ICD-10 guidelines, expert guidance and the vital features you need for correct coding and reimbursement.

Rob williams