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Prepare for new ICD-10-CM codes that take effect on Oct. 1 :

June 28, 2016

For the first time in many years, International Classification of Diseases codes will be updated. This will be the largest update to the code set due to the code freeze that was implemented during the lengthy transition to International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM).

The new codes will take effect on Oct. 1, so begin preparing now.

There will be 1,943 new codes, 422 revised codes and 305 “invalid” codes, which will have additional digits to further classify them.

This article and the August issue of Coding Corner will highlight nearly all changes and will include codes that are most relevant to pediatrics.

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 2 – Neoplasms

  • Several new codes for gastrointestinal stromal tumors (by site) (C49.A-), Castleman disease (D47.Z2), and kidney neoplasms of unspecified behaviors (D49.5-).


Chapter 3 – Diseases of the blood and bloodforming organs and certain disorders involving the immune mechanism

  • Several new codes related to mast cell activation (D89.4-)


Chapter 4 – Endocrine, nutritional and metabolic diseases

  • Roughly 260 new codes were added for diabetic retinopathy to discern laterality (E08 - E13)

E78.00 ‐ Pure hypercholesterolemia, UNSPEC

E78.01 ‐ Familial hypercholesterolemia


Chapter 5 – Mental, behavioral and neurodevelopmental disorders

F32.81 ‐ Premenstrual dysphoric disorder

F32.89 ‐ Other specified depressive episodes

F34.81 ‐ Disruptive mood dysregulation disorder

F34.89 ‐ Other specified persistent mood disorders

F42.2 ‐ Mixed obsessional thoughts and acts

F42.3 ‐ Hoarding disorder

F42.4  ‐ Excoriation (skin‐picking) disorder

F42.8  ‐ Other obsessive compulsive disorder

F42.9  ‐ Obsessive‐compulsive disorder, UNSPEC

F50.81 ‐ Binge eating disorder

F50.89 ‐ Other specified eating disorder

F64.0  ‐ Transsexualism

F80.82 ‐ Social pragmatic communication disorder


Chapter 6 – Diseases of the nervous system

  • New codes were created for bilateral carpal tunnel and tarsal tunnel syndrome, while several codes were developed for lesions on various nerves (bilateral upper and lower limbs) (G56- and G57-).
  • New codes were created for causalgia, mononeuropathy (other specified and unspecified) and meralgia paresthetica for bilateral limbs (upper and lower) (G57- and G61-).
  • A new code was created for multifocal motor neuropathy (G61.82).


Chapter 7 – Diseases of the eye and adnexa

  • New codes for central retinal (H34.81-) and tributary (branch) (H34.83-) vein occlusion were developed to differentiate whether the condition was stable or with specific complications.
  • New codes were developed to define specific stages and laterality for nonexudative age-related macular degeneration (H35.31-) as well as exudative macular degeneration (H35.32-).
  • New codes were developed to define laterality for primary open-angle glaucoma.

H53.041 ‐ Amblyopia suspect, right eye

H53.042 ‐ Amblyopia suspect, left eye

H53.043 ‐ Amblyopia suspect, bilateral


Chapter 8 – Diseases of the ear and mastoid process

H90.A11 ‐ Conductive hearing loss, right ear, with restricted hearing on the contralateral side

H90.A12 ‐ Conductive hearing loss, left ear, with restricted hearing on the contralateral side

H90.A21 ‐ Sensorineural hearing loss, right ear, with restricted hearing on the contralateral side

H90.A22 ‐ Sensorineural hearing loss, left ear, with restricted hearing on the contralateral side

H90.A31 ‐ Mixed conductive and sensorineural hearing loss, right ear, with restricted hearing on the contralateral side

H90.A32 ‐ Mixed conductive and sensorineural hearing, left ear, with restricted hearing on the contralateral side

H93.A1 ‐ Pulsatile tinnitus, right ear

H93.A2 ‐ Pulsatile tinnitus, left ear

H93.A3 ‐ Pulsatile tinnitus, bilateral


Chapter 9 – Diseases of the circulatory system

  • Bilateral codes were added for cerebral infarction due to thrombosis/embolism (I63-)
  • More specificity was added to each “cognitive deficit” sequela code to better discern the type of deficit suffered based on the condition (e.g., nontraumatic subarachnoid hemorrhage) (I69-)
  • New aneurysm codes (I72-) and dissection codes (I77.7-) also added 

I16.0 ‐ Hypertensive urgency

I16.1 ‐ Hypertensive emergency

I16.9 ‐ Hypertensive crisis, UNSPEC


Chapter 10 – Diseases of the respiratory system

  • New codes were added under diseases of mediastinum (J98.5)


Chapter 11 – Diseases of the digestive system

  • New codes for pulpitis (K04.0-)
  • New codes for aggressive periodontitis (K05.2-) and chronic periodontitis (K05.3-)
  • New codes for primary (K08.81) and secondary occlusal trauma (K08.82) and other specified disorder of teeth and supporting structures (K08.89)
  • New codes added for more specificity under colitis (K52.3, K52.8-)
  • Several new codes added under acute vascular disorders of intestine to specify location and type (K55.0-)
  • New codes under irritable bowel syndrome (K58-)
  • New constipation specificity (K59.0-) added along with new codes for megacolon (K59.3-)
  • Several new codes added for acute pancreatitis to discern type (e.g., idiopathic) (K85-)
  • New codes added under diseases of the pancreas (K86.8-)

K52.21 ‐ Food protein‐induced enterocolitis syndrome

K52.22 ‐ Food protein‐induced enteropathy

K52.29 ‐ Other allergic and dietetic gastroenteritis and colitis

K55.30 ‐ Necrotizing enterocolitis, UNSPEC

K55.31 ‐ Stage 1 necrotizing enterocolitis

K55.32 ‐ Stage 2 necrotizing enterocolitis

K55.33 ‐ Stage 3 necrotizing enterocolitis

K90.41 ‐ Non‐celiac gluten sensitivity

K90.49 ‐ Malabsorption due to intolerance, not elsewhere classified


Chapter 12 – Diseases of the skin and subcutaneous tissue

L03.213 ‐ Periorbital cellulitis

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

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