Below is an overview of the final rule as well as changes in various categories that may be important to you. There are 490 new, 47 revised, and 58 deleted ICD-10-CM diagnosis codes finalized for fiscal 2021 taking effect October 1, 2020.
The final rule includes hundreds of new ICD-10-CM codes:
- 128 additions to Chapter 19: Injury, poisoning and certain other consequences of external causes for adverse effects and poisoning by fentanyl and tramadol as well as other synthetic narcotics.
- 125 additions to Chapter 20: External causes of morbidity, including more specific codes for collisions involving electric scooters and other non-motor vehicle accidents.
- 57 musculoskeletal codes, including several in category M24.- (other specific joint derangements) for other articular cartilage disorders, disorders of ligament, pathological dislocation, recurrent dislocation, contracture, and ankyloses.
- 21 codes to describe withdrawal from substances including alcohol, cocaine, and opioids.
- 18 codes for sickle cell anemia. New codes such as D57.213 (sickle-cell/Hb-C disease with cerebral vascular involvement) and D57.431 (sickle-cell thalassemia beta zero with acute chest syndrome) specify complications related to the condition.
- Three codes to capture stage 3 chronic kidney disease (CKD) in two new sub-stages.
- New Chapter 22 Codes for Special Purposes includes two new codes this year: U07.0 (vaping-related disorders) and U07.1 (COVID-19).
Changes can be found in the following categories:
New
- D57 – sickle-cell disorders
- D89 – other disorders involving the immune mechanism- not elsewhere classified
- F10 – Alcohol abuse and use with withdrawal
- F19 – other psychoactive substance related disorders
- H18 – other disorders of cornea
- M05 – rheumatoid arthritis with rheumatoid factor
- M06 – other rheumatoid arthritis
- M08 – juvenile arthritis
- M19 – other and unspecified osteoarthritis
- M92 – Juvenile osteochondrosis
- S20- superficial injury of thorax
- T40- poisoning by- adverse effect of and under-dosing of narcotics and psychodysleptics (hallucinogens)
- V00-V06 for electric scooter and other micro-mobility pedestrian conveyance injuries
Revised
- Z68- Body mass index (BMI)
- Z88- Allergy status codes
Deleted
- T40- poisoning, under-dosing, and adverse effects of other synthetic narcotics
- 20- other doubling of the uterus, unspecified
Proposed FY 2021 ICD-10-CM Code Changes
| ICD-10-CM chapter | New | Revised | Invalid |
|---|---|---|---|
| Chapter 1: Certain infectious and parasitic diseases (A00-B99) | 7 | 0 | 2 |
| Chapter 2: Neoplasms (C00-D49) | 0 | 0 | 0 |
| Chapter 3: Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) | 43 | 3 | 3 |
| Chapter 4: Endocrine, nutritional and metabolic diseases (E00-E89) | 6 | 0 | 2 |
| Chapter 5: Mental, Behavioral and Neurodevelopmental disorders (F01-F99) | 21 | 0 | 0 |
| Chapter 6: Diseases of the nervous system (G00-G99) | 24 | 0 | 5 |
| Chapter 7: Diseases of the eye and adnexa (H00-H59) | 29 | 1 | 7 |
| Chapter 8: Diseases of the ear and mastoid process (H60-H95) | 0 | 0 | 0 |
| Chapter 9: Diseases of the circulatory system (I00-I99) | 0 | 0 | 0 |
| Chapter 10: Diseases of the respiratory system (J00-J99) | 6 | 0 | 2 |
| Chapter 11: Diseases of the digestive system (K00-K95) | 11 | 0 | 5 |
| Chapter 12: Diseases of the skin and subcutaneous tissue (L00-L99) | 0 | 0 | 0 |
| Chapter 13: Diseases of the musculoskeletal system and connective tissue (M00-M99) | 57 | 0 | 3 |
| Chapter 14: Diseases of the genitourinary system (N00-N99) | 15 | 0 | 1 |
| Chapter 15: Pregnancy, childbirth and the puerperium (O00-O9A) | 5 | 0 | 1 |
| Chapter 16: Certain conditions originating in the perinatal period (P00-P96) | 4 | 0 | 0 |
| Chapter 17: Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99) | 0 | 3 | 1 |
| Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) | 4 | 0 | 2 |
| Chapter 19: Injury, poisoning and certain other consequences of external causes (S00-T88) | 128 | 0 | 23 |
| Chapter 20: External causes of morbidity (V00-Y99) | 125 | 1 | 1 |
| Chapter 21: Factors influencing health status and contact with health services (Z00-Z99) | 3 | 39 | 0 |
| *Chapter 22: Codes for special purposes (U00-U85) | 2 | 0 | 0 |
| Total | 490 | 47 | 58 |
In addition, CMS proposed new guidelines for Evaluation and Management CPT codes, effective January 1st, 2021. These changes apply to new and established office or other outpatient visits (99201-99215).
- Code 99201 will be deleted.
- History and exam will not be used in determining which visit code is supported.
- Office level will be determined by time or medical decision making.
- New definitions within MDM are given with slight changes to how MDM is calculated.
- Visits will have assigned time ranges, defined as total spent on that date of service, including non-face-to-face work.
Join us on a webinar to talk about the new E/M Codes on October 27!
E/M Coding Webinar Information
Does this seem like a lot to tackle in the midst of the pandemic? Dean Dorton can help by offering comprehensive coding chart audits and provider documentation education to make sure you are in compliance.
Brandy Montgomery
Healthcare Consulting Manager
bmontgomery@ddafhealthcare.com • 502.566.1037