Here is the PART 3 of the ICD-10 CM 2021 changes. If you miss to read the part 1 and 2, you can refer the links provided below:
Pregnancy, childbirth and the puerperium (O00-O9A):
There are 5 new codes added, 1 code deleted and 0 revised codes.
Other specified diseases and conditions complicating pregnancy, childbirth and the puerperium: O99.89 – Deleted code
Code O99.89 is deleted and expanded to create unique codes with a sixth digit character to specify the obstetric-related stage of the patient, example: pregnancy, childbirth and puerperium.
O99.891 Other specified diseases and conditions complicating pregnancy
O99.892 Other specified diseases and conditions complicating childbirth
O99.893 Other specified diseases and conditions complicating puerperium
New code for Mid-Transverse T incision scar: O34.218
Currently in ICD-10 CM, under category O34, subcategory O34.2, there are codes listed to identify the maternal care due to uterine scar from previous surgery. These codes reflect the type of scar as low transverse scar (O34.211), vertical scar (O34.212) and unspecified type scar (O34.219). However there is no unique code to represent the “Mid-transverse T incision” scar. Now a new code O34.218 (Maternal care for other type scar from previous cesarean delivery) has been added to denote “other type scar” which also includes mid-transverse T incision scar.
New code for isthmocele: O34.22
An isthmocele is the result of incomplete healing of the isthmic myometrium after a low transverse uterine incision performed for cesarean section. Subcategory O34.2 is expanded further to a new code 034.22 to identify the condition of isthmocele.
Certain conditions originating in the perinatal period (P00-P96):
There are 4 new codes added to this chapter and 0 deleted codes.
A new subcategory P91.82 is added to report the neonatal cerebral infarction condition based on the proposals submitted by The American Academy of Pediatrics (AAP). Neonatal cerebral infarction (or stroke) is a cerebrovascular condition that occurs between 20 weeks of fetal life through to the 28th postnatal day. This condition is defined as a severe disorganization or even a complete disruption of the gray matter of the developing brain caused by embolic, thrombotic or ischemic events. As laterality is important to document for epidemiology, prognosis and follow-up, subcategory P91.82 is further expanded to identify the laterality component in its code description.
P91.821 Neonatal cerebral infarction, right side of brain
P91.822 Neonatal cerebral infarction, left side of brain
P91.823 Neonatal cerebral infarction, bilateral
P91.829 Neonatal cerebral infarction, unspecified side
Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99):
There are no major changes to this chapter; however there is one code deleted and three codes revised.
Other doubling of uterus, unspecified: Q51.20 – Deleted code
Revise from: Q51.21 Other complete doubling of uterus
Revise to: Q51.21 complete doubling of uterus
Revise from: Q51.22 other partial doubling of uterus
Revise to: Q51.22 partial doubling of uterus
Revise from: Q51.28 other doubling of uterus, other specified
Revise to: Q51.28 other and unspecified doubling of uterus
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99):
There are 2 codes deleted, 4 new codes added and 0 revised codes.
Headache: R51 – Deleted code
The most frequently used code R51 is now deleted and expanded into two new codes as below:
R51.0 Headache with orthostatic component, not elsewhere classified
R51.9 Headache, unspecified
Nonspecific elevation of levels of transaminase and lactic acid dehydrogenase [LDH]: R74.0 – Deleted code
ICD-10-CM currently classifies non-specific elevation of levels of transaminase and lactic acid dehydrogenase under a single code, R74.0 (Nonspecific elevation of levels of transaminase and lactic acid dehydrogenase [LDH]). As the elevations of different enzymes included in this code can result in different clinical treatment modalities, proposals were made to expand R74.0 to identify the enzymes separately.
R74.01 Elevation of levels of liver transaminase levels
R74.02 Elevation of levels of lactic acid dehydrogenase [LDH]
Injury, poisoning and certain other consequences of external causes (S00-T88):
There are 23 codes deleted, 128 new codes added and 0 revised codes. Several new codes are added to superficial injury of thorax and synthetic narcotic poisoning codes.
Superficial Injury of Thorax: New codes for bilateral and Middle injuries
The anterior thorax is one of the most common locations of traumatic injury. The current thorax injury codes do not describe either the bilateral or middle anatomical locations. Therefore several new codes are added to identify both the bilateral and middle injuries based on the American Academy of Pediatrics proposals.
Example: New codes S20.213 and S20.214 are added to identify the bilateral and middle injuries respectively.
S20.213 Contusion of bilateral front wall of thorax
S20.214 Contusion of middle front wall of thorax
S20.223 Contusion of bilateral back wall of thorax
S20.224 Contusion of middle back wall of thorax
The other change will include the addition of new codes to identify the poisoning by specific synthetic narcotics such as fentanyl and tramadol. Codes T40.4X are deleted and T40.41, T40.42, and T40.49 are added. These codes are further expanded to denote the intent and the encounter type.
Example of New codes:
T40.411 Poisoning by fentanyl or fentanyl analogs, accidental (unintentional)
T40.412 Poisoning by fentanyl or fentanyl analogs, intentional self-harm
T40.413 Poisoning by fentanyl or fentanyl analogs, assault
T40.414 poisoning by fentanyl or fentanyl analogs, undetermined
T40.415 Adverse effect of fentanyl or fentanyl analogs
T40.416 underdosing of fentanyl or fentanyl analogs
T40.421 Poisoning by tramadol, accidental (unintentional)
T40.422 Poisoning by tramadol, intentional self-harm
T40.423 Poisoning by tramadol, assault
T40.424 Poisoning by tramadol, undetermined
T40.425 Adverse effect of tramadol
T40.426 Underdosing of tramadol
T40.491 Poisoning by other synthetic narcotics, accidental (unintentional)
Poisoning by other synthetic narcotics NOS
T40.492 Poisoning by other synthetic narcotics, intentional self-harm
T40.493 Poisoning by other synthetic narcotics, assault
T40.494 Poisoning by other synthetic narcotics, undetermined
T40.495 Adverse effect of other synthetic narcotics
T40.496 Underdosing of other synthetic narcotics
Complications of Corneal transplant:
The current codes of corneal transplant complications such as rejection, failure, infection, other and unspecified complications are deleted and new codes are added to specify the laterality in the code description.
T86.840 Corneal transplant rejection
T86.841 Corneal transplant failure
T86.842 Corneal transplant infection
T86.848 other complications of corneal transplant
T86.849 Unspecified complication of corneal transplant
For example, code T86.840 is deleted and new codes are created to specify the laterality as below:
T86.8401 Corneal transplant rejection, right eye
T86.8402 Corneal transplant rejection, left eye
T86.8403 Corneal transplant rejection, bilateral
T86.8409 Corneal transplant rejection, unspecified eye
(The laterality specific codes are added to other complications too and you can find the full set of new codes in https://www.cms.gov/medicare/icd-10/2021-icd-10-cm)
External causes of morbidity (V00-Y99):
There are 125 new codes added, 1 code deleted and 1 code revised in this chapter. Several new codes are added to report injuries related to e-scooters and other micro-mobility devices.
A new subcategory V00.03 (Pedestrian on foot injured in collision with standing micro- mobility pedestrian conveyance) is added to include two new codes as below:
V00.031 Pedestrian on foot injured in collision with rider of standing electric scooter
V00.038 Pedestrian on foot injured in collision with rider of other standing micro-mobility pedestrian conveyance
Factors influencing health status and contact with health services (Z00-Z99):
There are 3 new codes added, 39 codes revised and 0 deleted codes in this chapter.
Encounter for suspected foreign body ingestion – New codes
There are new codes added to report the encounters for suspected foreign body ingestion. Foreign bodies can enter into human body through a variety of methods, including ingestion, aspiration and purposeful insertion. A thorough clinical examination is generally required to determine the presence of a foreign object in those suspected cases. Currently there are no codes available to identify and track such encounters. Therefore AAP requested new codes to identify patients who seek care for suspected foreign body ingestion, not found.
Z03.821 Encounter for observation for suspected ingested foreign body ruled out
Z03.822 Encounter for observation for suspected aspirated (inhaled) foreign body ruled out
Z03.823 Encounter for observation for suspected inserted (injected) foreign body ruled out
Z68 (body mass index) codes relating to both adult and pediatric body mass index
Z88 (allergy status to drugs, medicaments, and biological substances) codes.
Codes for special purposes (U00-U85):
The new Chapter 22 titled as”Codes for Special Purpose (U00-U85)” is added to include two new codes which already took effect in April 1, 2020 for use due to emergency.
U07.0 Vaping-related disorder
Happy learning! Happy coding!