2019 ICD‐10‐CM updates went into effect on October 1st. These changes will impact encounters for dates of service October 1, 2019 through September 30, 2020. It is imperative that your organization has up‐to‐date coding resources and a keen understanding of the changes that will impact your reimbursement! The new updates can also influence your organization’s MIPS/MACRA quality reporting scores.

This year’s ICD‐10‐CM updates include 325 code changes (273 new codes, 15 validity changes, 7 deleted codes, and 30 code revisions).

Here are notable highlights of the 2020 updates: 

  • Guideline Changes:
  • Coding Conventions Section 1.A.15 “with” update:

The word “with” in the Alphabetic Index is sequenced immediately following the main term or subterm, not in alphabetical order. o Chapter‐Specific Coding Guidelines updates:

New section 1.C.19.b.3 Iatrogenic injuries New section 1.C.19.c.3 Physeal Fractures New paragraph 1.C.19.e.4 Adverse Effects, Poisoning, Underdosing & Toxic Effects New paragraph 1.C.19.g.5: Complication of care New language 1.C.21.c.3: Z68 BMI codes should only be assigned when there is an associated, re-portable diagnosis (such as obesity). New paragraph 1.C.21.c.10: Factors influencing health status 

Note: Code Z71.84, encounter for health counseling related to travel, is to be used for health risk and safety counseling for future travel purposes.

  • Section IV.H. Uncertain Diagnosis has added two additional terms “compatible with & consistent with” as examples of documentation terms that cannot be coded, as they indicate uncertainty.

15 validity changes:

  •  H81.4 ‘vertigo of central origin’ was changed from invalid to valid

7 Codes Deleted:

  • Removal of laterality for ‘vertigo of central origin’ at category H81.4‐ o Heatstroke inclusion terms and adjustment of character assignment at T67.‐

273 new codes:

  • Four new codes at category I48 to increase specificity of atrial fibrillation o Ten new codes at category I80 to increase specificity/laterality of phlebitis o New codes for Pressure‐induced deep tissue damage at category L89 o Unspecified breast lumps in category N63 has new codes to identify “overlapping quadrants” o N99.85 Post endometrial ablation syndrome o Category Q66 for congenital foot conditions has 24 new codes to identify laterality o R11.15 cyclicial vomiting syndrome unrelated to migraine (persistent vomiting) o R82.81 pyuria
  • Many new additions to fractures in category S02.‐ o Many new additions to poisoning in category T50.‐ o Additions to category Y35.‐ for Legal interventions that are now categorized by 7th characters to identify episode of care o Z01.02‐ Encounter for exam of eyes & vision following failed vision screening (with or w/o abnormal findings) o New codes for tuberculosis: Latent TB screening Z11.7, Latent TB infection Z22.7 & personal history of latent TB infection Z86.15 o Encounter for health counseling related to travel Z71.84

*Please note this list is not all‐inclusive. For a comprehensive list of all 2020 ICD‐10‐CM changes, please visit the CMS website.