As per the new ICD 10 updates, some new guidelines need to follow from Q3 october 2022. Chapterwise their are some ICD 10 codes which are added newly in codebook like B04 for monkeypox disease. Also we will see some of the important changes in ICD 10 codes from Q3 2022.
ICD 10 Coding for Monkeypox
Monkeypox is an uncommon infection caused by the monkeypox virus, which is similar to the virus responsible for smallpox. Monkeypox is rarely fatal and does not cause severe disease as smallpox does. Below ICD 10 codes are use for the Monkeypox and its history condition.
- Monkeypox – ICD-10-CM code B04
- Follow-up visits for monkeypox after lesions have healed and no longer infectious
Primary diagnosis – Z09 (Follow-up examination after completed treatment)
Secondary diagnosis – Z86.19 (Personal history of other infectious and parasitic diseases)
ICD 10 coding for Intracerebral hemorrhages (ICH) associated with brain metastasis
As per the coding guidelines, when the reason for admission is to treat a complication of a neoplasm, sequence the complication first.
- Example – facial droop, aphasia related to ICH assign I61.9 (non-traumatic intracerebral hemorrhage, unspecified) as PDX with additional code for brain metastasis (C79.31)
Also when the reason for admission is to treat the brain metastasis who also has an intracerebral hemorrhage
- Example – ataxia, double vision after work-up revealed ICH and brain metastasis – proceed with surgical resection of brain metastasis. Assign C79.31 as PDX then code I61.9 for ICH.
Coding rule for Malignant pleural effusion
An active breast cancer patient is admitted with malignant pleural effusion is treated with thoracentesis. As per the coding guidelines, or the instruction notes in tabular list, the underlying neoplasm should be sequenced first followed by J91.0
Coding guide for Myasthenia gravis
Myasthenia gravis (MG) is a chronic autoimmune disorder in which antibodies destroy the communication between nerves and muscle, resulting in weakness of the skeletal muscles. When Myasthenia Gravis is documented with Diabetes and Chronic Kidney Disease (CKD), we have to code them separately.
Assign G70.00 (Myasthenia gravis w/o exacerbation)
Assign E11.22 (Type 2 with diabetic CKD)
Assign N18- (for specific stage of CKD)
As per the coding guideline, Do Not assign E11.44 for myasthenia gravis
Coding guide for Metabolic Syndrome
When Patient is admitted for a bariatric surgery due to “clinically severe obesity” and “metabolic syndrome”
Assign E88.81 (metabolic syndrome) as Primary diagnosis followed by below diagnosis.
Assign E66.01 (“severe” obesity)
Assign Z code for BMI (Z68.3-)
ICD 10 code for Benign recurrent intrahepatic cholestasis (BRIC)
Assign E80.6 – Other disorders of bilirubin metabolism
Assign K76.89 – Other specified diseases of the liver
ICD 10 code for Blood clot partially obstructing the main bronchus
Assign J98.09 (Other diseases of the bronchus, NEC)
This is not considered a pulmonary embolism since it did not involve the pulmonary vessels.
Coding History of lymphoma
Below ICD 10 codes should be assigned for History of lymphoma
Z85.72 (Personal history of lymphoma (non-Hodgkin)
History of non-Hodgkin lymphoma in remission with no evidence of disease (NED)
Z85.72 (Personal history of lymphoma (non-Hodgkin)
