Final ICD-10-CM codes for FY 2020 includes new and deleted codes. 

The Centers for Medicare & Medicaid Services (CMS) released the final ICD-10-CM codes for the 2020 fiscal year on June 21, 2019.   

This release included a total of 72,184 diagnosis codes for the MS-DRG V37. The changes include 273 new codes, 21 deleted codes, and 30 description revisions. The final diagnosis update is exactly what was predicted in the Proposed Rule. The new codes will be effective Oct. 1, 2019, through Sept. 30, 2020.

Chapters 1, 2, 4, 5, 6, 7, 10, 11, 13, 15, and 16 do not have any new codes. Chapter 3 (Diseases of the Blood and Blood Forming Organs) has five new codes that cover various adenosine deaminase deficiencies and glucose-6-phosphate-dehydrogenase deficiency (G6PD). Chapter 8 (Diseases of the Ear and Mastoid Process) has the addition of vertigo of central origin. Chapter 9 (Diseases of the Circulatory System) has 30 new codes, which cover various types of atrial fibrillation and phlebitis/thrombophlebitis expanded to new veins, and these include laterality.   

Chapter 12 (Diseases of Skin and Subcutaneous Tissue) has 25 new codes, which mark additions to category L89 (Pressure Ulcer). Pressure-induced deep tissue damage is a new type of pressure ulcer that was added and is identified by the sixth character of “6.” The new codes are added to each site, including laterality.

Chapter 14 (Diseases of the Genitourinary System) has three new codes. Two codes capture an unspecified breast lump that overlaps quadrants. The third code, N99.85, was created to capture post-endometrial ablation syndrome. This syndrome is chronic and recurrent pelvic pain as an after-effect of endometrial ablation, which is a procedure that removes or destroys the endometrial lining of the uterus.

Chapter 17 (Congenital Malformations, Deformations, and Chromosomal Abnormalities) has 31 new codes. These codes include various congenital foot deformities, expansion of Ehlers-Danlos Syndrome, and additional codes for congenital malformations of syndromes generally associated with short stature. One new code, Q87.11, specifies Prader-Willi Syndrome. This genetic syndrome presents with severe hypotonia. The infants born with this syndrome have feeding difficulties, which lead to severe obesity if not controlled. 

Chapter 18 (Symptoms, Signs, and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified) has three new codes. The new codes include R11.15 (cyclical vomiting syndrome unrelated to migraine); R82.81 (pyuria); and R82.89 (other abnormal findings on cytology/histology exam of urine).  

Chapter 19 (Injuries, Poisoning, and Certain Consequences of External Causes) has 87 new codes.  These codes cover only three areas: orbital fractures, poisoning/adverse effect of multiple medicaments, and heatstroke.   

Chapter 20 (External Cause of Morbidity) has 20 new codes, which focus on legal intervention with specific objects. The objects include firearms, explosives, gas, blunt objects, sharp objects, and conducted energy. Chapter 20 codes include the seventh character of A (initial encounter), D (subsequent encounter), and S (sequela).

Chapter 21 (Factors Influencing Health Status and Contact with Health Service) has thirteen new codes. These new codes cover the topics of an encounter following a failed eye exam, testing/history of latent tuberculosis, encounter for health counseling related to travel, personal history of in-situ neoplasm, and presence of neurostimulators. The cancer registries are looking forward to capturing the personal history of in-situ neoplasms in healthcare data. 

The final PDF files for the Index and Tabular are available at the resource listed below. It is important to review the code changes and begin to educate coders, clinical documentation professionals, and physicians regarding the changes. One piece of the pie that is missing is the final complications and comorbidities (CCs) and major CCs (MCCs) designations. That information will come with the Inpatient Prospective Payment System Final Rule for FY 2020.

The fireworks will begin soon!


Programming Note:

Listen to Laurie Johnson report this story live today during Talk Ten Tuesday, 10-10:30 a.m. EST.




Laurie M. Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10-CM/PCS Trainer

Laurie Johnson is currently a senior healthcare consultant for Revenue Cycle Solutions, based in Pittsburgh, Pa. Laurie is an AHIMA-approved ICD-10-CM/PCS trainer. She has more than 35 years of experience in health information management and specializes in coding and related functions. She has been a featured speaker in over 40 conferences. Laurie is a member of the ICD10monitor editorial board and is a permanent panelist on Talk Ten Tuesdays

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