Specialty-Specific ICD-10 Changes for FY2020 (Beginning Oct. 1, 2019)

The Centers for Medicare & Medicaid services (CMS), Centers for Disease Control and Prevention (CDC) and National Center for Health Statistics (NCHS) jointly released the official ICD-10 code changes for fiscal year (FY) 2020. This is the fourth such update to occur since ICD-10 was first officially implemented in the U.S. back in October of 2015. These code changes will go into immediate effect as of Tuesday, October 1, 2019. However, it is important to note that any claims with earlier service dates (on or before September 30, 2019) must continue to use the codes from FY2019.

The FY2020 list of ICD-10 codes has somewhat expanded, now containing 72,184 diagnosis codes (a slight increase from the previous set of 71,932 diagnosis codes). In this blog, we will take a look at a few points of interest for specialty practices. This article is only intended to offer our readers with some basic important information on the upcoming coding changes and is in no way meant to serve as a comprehensive explanation of all the new changes. For a deep dive list of everything that’s been changed, we recommend you check out the CDC's Tabular List of Diseases and Injuries.

Ophthalmology Changes

Those in Ophthalmology will be seeing some of the most significant changes, with 70 new codes and 5 codes being deleted. Some of the most important changes are as follows:

• Ehlers-Danlos Syndrome (EDS) code has been replaced (Q79) and had a fifth character code added, making it easier to indicate both common and severe types of EDS
• Vertigo of Central Origin (H81.4) is now a reportable code
• Subcategories have been added to specify Fractures of the Orbital Roof and Individual Orbital Walls
• Removed the additional character for ear references from Vertigo of Central Origin (right, left, bilateral, and unspecified)

For more details, please go to the CMS Official Lists.

Dermatology Changes

For specialty providers in Dermatology, there have been changes made to the coding for Pressure Ulcers:

• L89 – now classifies pressure ulcer stages based on severity, which is designated by stages 1-4, deep tissue pressure injury, unspecified stage, and unstageable

For more information, check out page 55 of the CDC Guide.

Plastics Changes

For plastics, the main change to be aware of refers to surgical aftercare:

• Z42 – Encounter for plastic and reconstructive surgery following medical procedure or healed injury

For more information, check out page 100 of the CDC Guide.

Orthopedics Changes

For specialty providers in Orthopedics, there are changes in surgical aftercare as well as for coding musculoskeletal conditions:

• Z47 – Orthopedic aftercare
• M00-M99 – for “Diseases of the Musculoskeletal System and Connective Tissue,” these codes have been expanded to include site and severity. According to the CDC guide, “The site represents the bone, joint or the muscle involved. For some conditions where more than one bone, joint or muscle is usually involved, such as osteoarthritis, there is a ‘multiple sites’ code available. For categories where no multiple site code is ICD-10-CM Official Guidelines for Coding and Reporting FY 2020 Page 58 of 121 provided and more than one bone, joint or muscle is involved, multiple codes should be used to indicate the different sites involved.”

For more information, check out the CMS Coding Guidelines.

You’ve Got This

These new ICD-10 changes shouldn’t come as much of a surprise, since they were first released way back in August of 2019. However, it might be a good idea to brush up on the changes that effect your specialty to make sure your practice does not suffer any unexpected claim denials and/or reimbursement refusals. With just a bit of quick study, you should be on track for coding with ICD-10 in FY2020.

Need help with ICD-10? Contact our team at 866-654-4396.