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New ICD-10-CM codes take effect Oct. 1 :

July 14, 2016

Editor’s note: This is the second article on new International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes relevant to pediatrics that will take effect on Oct. 1. The first article is available at

The dash (-) used within a code indicates more digits are required. Unspecified laterality codes were included within the ICD-10-CM code set, but those codes are not included in this article.

Chapter 13 – Diseases of the musculoskeletal system and connective tissue

  • New codes added for autoinflammatory syndromes (M04-) including periodic fever syndromes (M04.1) and cryopyrin‐associated periodic syndromes (M04.2)
  • New codes added for bunions (M21.61-) and bunionettes (M21.62-)
  • New codes added for temporomandibular joint disorder specificity (M26.6-)
  • New codes added for specific levels to define cervical disc displacement (M50-)
  • Several new codes for atypical femoral fracture (including type of encounter required for each) were added for type and laterality (M84.75-)
  • Several new codes for periprosthetic fracture around internal prosthetics were added to specify joint and laterality (including type of encounter) (M97-)
M25.541  Pain in joints of right hand
M25.542  Pain in joints of left hand

Chapter 14 – Diseases of the genitourinary system

  • New codes added for laterality for follicular, corpus luteum, and other and unspecified ovarian cysts (N83-)  
  • New codes for laterality for ovarian torsion and ovarian pedicle (N83.51-) and torsion of fallopian tubes (N83.52-)
  • New codes added for complications of stoma of urinary tract (N99.52- and N99.53-)

N13.0    Hydronephrosis with ureteropelvic junction obstruction

N90.60   UNSPEC hypertrophy of vulva

N90.61   Childhood asymmetric labium majus enlargement (CALME)

N90.69   Other specified hypertrophy of vulva

N93.1    Pre‐pubertal vaginal bleeding

N50.811  Right testicular pain

N50.812  Left testicular pain

N50.819  Testicular pain, UNSPEC

N50.82  Scrotal pain

Chapter 15 – Pregnancy, childbirth and the puerperium 

Refer to the ICD-10-CM manual 

Chapter 16   Certain conditions originating in the perinatal period

P05.09  Newborn light for gestational age, 2,500 grams and over

P05.19  Newborn small for gestational age, other

Chapter 17  Congenital malformations, deformations and chromosomal abnormalities

Q25.21  Interruption of aortic arch

Q25.29  Other atresia of aorta

Q25.40  Congenital malformation of aorta UNSPEC

Q25.41  Absence and aplasia of aorta

Q25.42  Hypoplasia of aorta

Q25.43  Congenital aneurysm of aorta

Q25.44  Congenital dilation of aorta

Q25.45  Double aortic arch

Q25.46  Tortuous aortic arch

Q25.47  Right aortic arch

Q25.48  Anomalous origin of subclavian artery

Q25.49  Other congenital malformations of aorta

Q52.120 Longitudinal vaginal septum, nonobstructing

Q52.121 Longitudinal vaginal septum, obstructing, right side

Q52.122  Longitudinal vaginal septum, obstructing, left side

Q52.123  Longitudinal vaginal septum, microperforate, right side

Q52.124  Longitudinal vaginal septum, microperforate, left side

Q52.129  Other and UNSPEC longitudinal vaginal septum

Q66.21  Congenital metatarsus primus varus

Q66.22  Congenital metatarsus adductus

Q87.82  Arterial tortuosity syndrome

Chapter 18 ‐ Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified

  • New codes added for more specificity for the National Institutes of Health Stroke Scale score (R29.7-)
  • New codes added for more specificity for the Glasgow coma scale (R40.24-)

R31.21  Asymptomatic microscopic hematuria

R31.29  Other microscopic hematuria

R73.03  Prediabetes

R82.71  Bacteriuria

R82.79  Other abnormal findings on microbiological examination of urine

R93.41  Abnormal radiologic findings on diagnostic imaging of renal pelvis, ureter or bladder

R93.421  Abnormal radiologic findings on diagnostic imaging of right kidney

R93.422  Abnormal radiologic findings on diagnostic imaging of left kidney

R93.49  Abnormal radiologic findings on diagnostic imaging of other urinary organs 

Chapter 19  Injury, poisoning and certain other consequences of external causes
  • New codes added to define laterality and encounter type under fracture of skull and facial bones (S02-)
  • New codes added to define laterality and encounter type under dislocation of jaw (S03.01-) and sprain of jaw (S03.41-)
  • New codes to define laterality and encounter type for other fracture of foot (S92.81-)
  • New codes (and subcategories) for Salter-Harris Type physeal fractures of ankle or foot specified by bone, type of fracture and encounter type (S99.0-, S99.1, S99.2-)
  • New codes added under “complications of cardiac and vascular prosthetic devices, implants and grafts” for stenosis of specific stents (T82.85-)
  • New codes added under mechanical complication of
    • urinary (indwelling) catheter to define type of complication (breakdown, displacement, leakage, other) and location (T83.0-)
    • urinary stents to define type of complication (T83.1-) 
    • urinary organ (erosion or exposure) (T83.2-)
    • testicular prosthesis to define type of complication (T83.4-) 
  • New codes added under infection and inflammatory reaction due to prosthetic device, implant and graft in urinary system (T83.5-) and infection and inflammatory reaction due to prosthetic device, implant and graft in genital tract (T83.6-) to define type of device and encounter 
  • New codes added under erosion of implanted mesh and other prosthetic materials (T83.71-) and exposure of implanted mesh and other prosthetic materials (T83.72-) in(to) surrounding organ or tissue to specify types of materials 
  • New codes added under mechanical complication of electronic neurostimulator generator to define type of complication (e.g., breakdown, displacement) and encounter (T85.1-)
  • New codes added for mechanical complication (e.g., breakdown, displacement) of other specified internal and external prosthetic devices, implants and grafts (T85.6-)
  • New codes added for infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts for the nervous system (T85.73-)
  • New codes added for embolism (T85.81-), fibrosis (T85.82-), hemorrhage (T85.83-), pain (T81.84), stenosis (T85.85-), thrombosis (T85.86-) and other specified complication to nervous system prosthetic devices
  • New code added for unintended awareness under general anesthesia during procedure (T88.53X-)


Becky Dolan, in the AAP Division of Health Care Finance, contributed to this article.

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