2019 ICD-10 Changes

by Danielle Zarnowiec, MBA | Sep 5, 2018 | ,

List of ICD-10 Codes for Dermatology, Ophthalmology, Orthopedics and Gastroenterology

October 1 gets closer each day, and the 473 ICD-10 changes have been published for the upcoming year. This includes 279 new ICD-10 codes, 143 revised codes and 51 deleted codes focused primarily around the theme of increased specificity. These new codes will apply to coding from October 1, 2018, through September 30, 2019.

Elana Oberstein, MD and Medical Director of Musculoskeletal, shared, “The new 2019 ICD-10 additions helped add more specificity for the classifications of certain conditions. For example, in the musculoskeletal subject area, we now have the ability to better specify an illness. If a patient has a muscular dystrophy, we can detail if this is a Duchenne or Becker variant or a Fascioscapulohumeral muscular dystrophy. This level of granularity can improve documentation and thus, a better understanding of affected patients.”

So how do you prepare for these ICD-10 changes when it comes to your electronic health record (EHR) system? The answer includes having an EHR system with these ICD-10 changes built in. Modernizing Medicine’s specialty-specific and cloud EHR system, EMA™, offers just this.

In addition to having an EHR system that’s prepared for such industry changes, it’s a good idea to stay in the know. Here are a few tips:

  1. Familiarize yourself with the changes relevant to your medical specialty. Stay updated with changes through official sources such as the CDC and CMS. Industry blogs and websites such as ICD10Monitor.com and AAPC.com could be great resources as well.
  2. Do your research. Understand the rationale behind the changes.
  3. Host sessions to educate your staff and encourage and support attendance at relevant conferences.  

This post highlights the 2019 ICD-10 codes for dermatology, ophthalmology, orthopedics, pain medicine and gastroenterology. For a complete list of ICD-10 codes and additional details on the changes, please visit the Center for Disease Control and Prevention’s website here.

2019 ICD-10 Codes for Dermatology, Plastic Surgery and Ophthalmology

Malignant melanoma of skin of eyelid, including canthus (GREATER SPECIFICITY)
C43.111 Malignant melanoma of right upper eyelid, including canthus
C43.112 Malignant melanoma of right lower eyelid, including canthus
C43.121 Malignant melanoma of left upper eyelid, including canthus
C43.122 Malignant melanoma of left lower eyelid, including canthus
Unspecified malignant neoplasm of skin of eyelid, including canthus (GREATER SPECIFICITY)
C44.1021 Unspecified malignant neoplasm of skin of right upper eyelid,including canthus
C44.1022 Unspecified malignant neoplasm of skin of right lower eyelid,including canthus
C44.1091 Unspecified malignant neoplasm of skin of left upper eyelid,including canthus
C44.1092 Unspecified malignant neoplasm of skin of left lower eyelid,including canthus
Basal cell carcinoma of skin of eyelid, including canthus (GREATER SPECIFICITY)
C44.1121 Basal cell carcinoma of skin of right upper eyelid, including canthus
C44.1122 Basal cell carcinoma of skin of right lower eyelid, including canthus
C44.1191 Basal cell carcinoma of skin of left upper eyelid, including canthus
C44.1192 Basal cell carcinoma of skin of left lower eyelid, including canthus
Squamous cell carcinoma of skin of eyelid, including canthus (GREATER SPECIFICITY)
C44.1221 Squamous cell carcinoma of skin of right upper eyelid, including canthus
C44.1222 Squamous cell carcinoma of skin of right lower eyelid, including canthus
C44.1291 Squamous cell carcinoma of skin of left upper eyelid, including canthus
C44.1292 Squamous cell carcinoma of skin of left lower eyelid, including canthus
Sebaceous cell carcinoma of skin of eyelid, including canthus (GREATER SPECIFICITY)
C44.1321 Sebaceous cell carcinoma of skin of right upper eyelid, including canthus
C44.1322 Sebaceous cell carcinoma of skin of right lower eyelid, including canthus
C44.1391 Sebaceous cell carcinoma of skin of left upper eyelid, including canthus
C44.1392 Sebaceous cell carcinoma of skin of left lower eyelid, including canthus
Other specified malignant neoplasm of skin of eyelid,including canthus (GREATER SPECIFICITY)
C44.1921 Other specified malignant neoplasm of skin of right upper eyelid,including canthus
C44.1922 Other specified malignant neoplasm of skin of right lower eyelid,including canthus
C44.1991 Other specified malignant neoplasm of skin of left upper eyelid,including canthus
C44.1992 Other specified malignant neoplasm of skin of left lower eyelid,including canthus
Merkel cell carcinoma of skin of eyelid, including canthus (GREATER SPECIFICITY)
C4A.111 Merkel cell carcinoma of right upper eyelid, including canthus
C4A.112 Merkel cell carcinoma of right lower eyelid, including canthus
C4A.121 Merkel cell carcinoma of left upper eyelid, including canthus
C4A.122 Merkel cell carcinoma of left lower eyelid, including canthus
Melanoma in situ of skin of eyelid, including canthus (GREATER SPECIFICITY)
D03.111 Melanoma in situ of right upper eyelid, including canthus
D03.112 Melanoma in situ of right lower eyelid, including canthus
D03.121 Melanoma in situ of left upper eyelid, including canthus
D03.122 Melanoma in situ of left lower eyelid, including canthus
Carcinoma in situ of skin of skin of eyelid,including canthus (GREATER SPECIFICITY)
D04.111 Carcinoma in situ of skin of right upper eyelid, including canthus
D04.112 Carcinoma in situ of skin of right lower eyelid, including canthus
D04.121 Carcinoma in situ of skin of left upper eyelid, including canthus
D04.122 Carcinoma in situ of skin of left lower eyelid, including canthus
Melanocytic nevi of eyelid, including canthus (GREATER SPECIFICITY)
D22.111 Melanocytic nevi of right upper eyelid, including canthus
D22.112 Melanocytic nevi of right lower eyelid, including canthus
D22.121 Melanocytic nevi of left upper eyelid, including canthus
D22.122 Melanocytic nevi of left lower eyelid, including canthus
Other benign neoplasm of skin of eyelid, including canthus (GREATER SPECIFICITY)
D23.111 Other benign neoplasm of skin of right upper eyelid, including canthus
D23.112 Other benign neoplasm of skin of right lower eyelid, including canthus
D23.121 Other benign neoplasm of skin of left upper eyelid, including canthus
D23.122 Other benign neoplasm of skin of left lower eyelid, including canthus
Clonic hemifacial spasm (GREATER SPECIFICITY)
G51.31 Clonic hemifacial spasm, right
G51.32 Clonic hemifacial spasm, left
G51.33 Clonic hemifacial spasm, bilateral
G51.39 Clonic hemifacial spasm, unspecified
Infection following a procedure (GREATER SPECIFICITY)
T81.40 Infection following a procedure, unspecified
T81.41 Infection following a procedure, superficial incisional surgical site
T81.42 Infection following a procedure, deep incisional surgical site
T81.43 Infection following a procedure, organ and space surgical site

2019 Ophthalmology ICD-10

Unspecified blepharitis (ADDITIONS TO THE EXISTING SERIES)
H01.00A Unspecified blepharitis right eye, upper and lower eyelids
H01.00B Unspecified blepharitis left eye, upper and lower eyelids
Ulcerative blepharitis (ADDITIONS TO THE EXISTING SERIES)
H01.01A Ulcerative blepharitis right eye, upper and lower eyelids
H01.01B Ulcerative blepharitis left eye, upper and lower eyelids
Squamous blepharitis (ADDITIONS TO THE EXISTING SERIES)
H01.02A Squamous blepharitis right eye, upper and lower eyelids
H01.02B Squamous blepharitis left eye, upper and lower eyelids
Paralytic ectropion of eyelid (NEW SERIES)
H02.151 Paralytic ectropion of right upper eyelid
H02.152 Paralytic ectropion of right lower eyelid
H02.153 Paralytic ectropion of right eye, unspecified eyelid
H02.154 Paralytic ectropion of left upper eyelid
H02.155 Paralytic ectropion of left lower eyelid
H02.156 Paralytic ectropion of left eye, unspecified eyelid
H02.159 Paralytic ectropion of unspecified eye, unspecified eyelid
Unspecified lagophthalmos (ADDITIONS TO THE EXISTING SERIES)
H02.20A Unspecified lagophthalmos right eye, upper and lower eyelids
H02.20B Unspecified lagophthalmos left eye, upper and lower eyelids
H02.20C Unspecified lagophthalmos, bilateral, upper and lower eyelids
Mechanical lagophthalmos (ADDITIONS TO THE EXISTING SERIES)
H02.22A Mechanical lagophthalmos right eye, upper and lower eyelids
H02.22B Mechanical lagophthalmos left eye, upper and lower eyelids
H02.22C Mechanical lagophthalmos, bilateral, upper and lower eyelids
Paralytic lagophthalmos (ADDITIONS TO THE EXISTING SERIES)
H02.23A Paralytic lagophthalmos right eye, upper and lower eyelids
H02.23B Paralytic lagophthalmos left eye, upper and lower eyelids
H02.23C Paralytic lagophthalmos, bilateral, upper and lower eyelids
Meibomian gland dysfunction of eyelid (NEW SERIES)
H02.881 Meibomian gland dysfunction right upper eyelid
H02.882 Meibomian gland dysfunction right lower eyelid
H02.883 Meibomian gland dysfunction of right eye, unspecified eyelid
H02.884 Meibomian gland dysfunction left upper eyelid
H02.885 Meibomian gland dysfunction left lower eyelid
H02.886 Meibomian gland dysfunction of left eye, unspecified eyelid
H02.88A Meibomian gland dysfunction right eye, upper and lower eyelids
H02.88B Meibomian gland dysfunction left eye, upper and lower eyelids
Rosacea conjunctivitis (NEW SERIES)
H10.821 Rosacea conjunctivitis, right eye
H10.822 Rosacea conjunctivitis, left eye
H10.823 Rosacea conjunctivitis, bilateral
H10.829 Rosacea conjunctivitis, unspecified eye
Brow ptosis (NEW SERIES)
H57.811 Brow ptosis, right
H57.812 Brow ptosis, left
H57.813 Brow ptosis, bilateral
H57.819 Brow ptosis, unspecified
Other specified disorders of eye and adnexa (NEW CODE)
H57.89 Other specified disorders of eye and adnexa

Gastroenterology ICD-10 for 2019

Acute appendicitis with generalized peritonitis (GREATER SPECIFICITY)
K35.20 Acute appendicitis with generalized peritonitis, without abscess
K35.21 Acute appendicitis with generalized peritonitis, with abscess
Acute appendicitis with localized peritonitis (GREATER SPECIFICITY)
K35.30 Acute appendicitis with localized peritonitis, without perforation or gangrene
K35.31 Acute appendicitis with localized peritonitis and gangrene, without perforation
K35.32 Acute appendicitis with perforation and localized peritonitis, without abscess
K35.33 Acute appendicitis with perforation and localized peritonitis, with abscess
Other and unspecified acute appendicitis (GREATER SPECIFICITY)
K35.890 Other acute appendicitis without perforation or gangrene
K35.891 Other acute appendicitis without perforation, with gangrene
Ischiorectal abscess (GREATER SPECIFICITY)
K61.31 Horseshoe abscess
K61.39 Other ischiorectal abscess
K61.5 Supralevator abscess
K80 Cholelithiasis Series (NEW INSTRUCTION)
Use Additional code if applicable for associated gangrene of gallbladder (K82.A1), or perforation of gallbladder (K82.A2)
Disorders of gallbladder in diseases classified elsewhere (NEW CODES)
K82.A1 Gangrene of gallbladder in cholecystitis
K82.A2 Perforation of gallbladder in cholecystitis
Cholangitis (GREATER SPECIFICITY)
K83.01 Primary sclerosing cholangitis
K83.09 Other cholangitis

Orthopedic ICD-10 and Interventional Pain Management

Myalgia (GREATER SPECIFICITY)
M79.10 Myalgia, unspecified site
M79.11 Myalgia of mastication muscle
M79.12 Myalgia of auxiliary muscles, head and neck
M79.18 Myalgia, other site
Muscular dystrophy (GREATER SPECIFICITY)
G71.00 Muscular dystrophy, unspecified
G71.01 Duchenne or Becker muscular dystrophy
G71.02 Facioscapulohumeral muscular dystrophy
Infection following a procedure (GREATER SPECIFICITY)
T81.40 Infection following a procedure, unspecified
T81.41 Infection following a procedure, superficial incisional surgical site
T81.42 Infection following a procedure, deep incisional surgical site
T81.43 Infection following a procedure, organ and space surgical site

Sources

Center for Disease Control and Prevention. International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). https://www.cdc.gov/nchs/icd/icd10cm.htm. Published July 26, 2018. Accessed August 20, 2018.

Centers for Medicare and Medicaid Services. CMS Releases ICD-10 Assessment and Maintenance Toolkit. https://www.cms.gov/Medicare/Coding/ICD10/index.htmlPublished May 17, 2018. Accessed August 20, 2018.

Danielle Zarnowiec, MBA

Danielle Zarnowiec, MBA

Requirements Analyst

Danielle Zarnowiec joined Modernizing Medicine in October 2012 and in her current role she serves as the team lead for EMA’s Medical Coding Engine and RCM’s Intelligent Claims Engine.

Previously, Danielle was the owner and operator of a Revenue Cycle Management (RCM) company specializing in medical coding consulting, revenue cycle management and physician quality reporting.

Danielle earned a bachelor’s degree in business administration from St. Andrews University where she served as captain of the NCAA women’s soccer and tennis teams. She then graduated from Palm Beach Atlantic University with an MBA in international business.

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