Master 2017 ICD-10-CM & ICD-10-PCS

Changes in Minutes
Presented By:
Rachel M. Kaser, BS, CPC, MHSA
AHIMA-Approved ICD-10-CM/PCS Trainer

Course Objectives
Tackle new, revised, deleted ICD-10 codes taking effect October 1,
2016
Boost coding productivity and avoid setbacks to reimbursement
Ensure accurate code selection for compliance
Obtain maximum reimbursement for services rendered using expert
tools
Guard Against Denials -- Prepare for changes now!

What Changed?
5 years since any updates to the ICD-10-CM code set
2017 will see over 1900 new codes; 350+ revised codes
Chapter by chapter overview of new, deleted, and revised codes
Logic of major changes and issuance of new codes
Guideline changes and pertinent background information on
new/revised codes

What Changed?
422 revised codes and 305 deleted codes for FY 2017
Better code options for Nexplanon contraceptive management
Clinical guidance and examples on the dependence classifications for
nicotine, which include:

Uncomplicated,
In remission,
With withdrawal,
With other nicotine-induced disorders; and
Unspecified nicotine-induced disorders

ICD-10-CM Tabular List

Excludes1 change to Excludes 2 notes:
Reporting a code together with codes from its Excludes1 list may be
appropriate when the conditions are unrelated

Interim Rule:
If the two conditions are not related to one another, it is permissible to report
both codes despite the presence of an Excludes1 note

Chapter 1 Certain Infectious and Parasitic

Diseases (A00 B99)
Addition of Zika Virus Disease:

Chapter 2 Neoplasms (C00 D49)

Multiple changes for codes related to Neoplasms:
Numerous code title revisions throughout this chapter
Seven new codes added

Example of revisions include:

Chapter 3 Diseases of the Blood

(D50 D89)
Changes to this chapter include additional codes, revisions and deletions:
D3A094

Revise from Benign carcinoid tumor of the foregut NOS

D3A094

Revise to

D3A095

Revise from Benign carcinoid tumor of the midgut NOS

D3A095

Revise to

D3A096

Revise from Benign carcinoid tumor of the hindgut NOS

D3A096

Revise to

Benign carcinoid tumor of the hindgut, unspecified

D47Z2

Add

Castleman disease

D495

Delete

Neoplasm of unspecified behavior of other genitourinary organs

D49511

Add

Neoplasm of unspecified behavior of right kidney

D49512

Add

Neoplasm of unspecified behavior of left kidney

D49519

Add

Neoplasm of unspecified behavior of unspecified kidney

D4959

Add

Neoplasm unspecified behavior of other genitourinary organ

D7821

Revise from Postprocedural hemorrhage and hematoma of the spleen following a procedure on the spleen

D7821

Revise to

D7822

Revise from Postprocedural hemorrhage and hematoma of the spleen following other procedure

D7822

Revise to

Benign carcinoid tumor of the foregut, unspecified

Benign carcinoid tumor of the midgut, unspecified

Postprocedural hemorrhage of the spleen following a procedure on the spleen

Postprocedural hemorrhage of the spleen following other procedure

Chapter 3 Diseases of the Blood

(D50 D89)
Changes to this chapter include additional codes, revisions and deletions:

Chapter 4 Endocrine, Nutritional and

Metabolic Diseases (E00 E89)
Updates to this chapter include:
260 new Diabetes combination codes
Utilized to report commonly associated manifestations and complications

Further specificity of diabetic retinopathy

Proliferative vs. non-proliferative
Severity of mild, moderate, severe

Addition of new code:

Z79.84: Long term (current) use of oral hypoglycemic drugs

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Chapter 5 Mental and Behavioral Issues

(F01 F99)
Updates to this chapter include additions of:
F42.3: Hoarding
Obsessive-compulsive disorders:
F422

Add

Mixed obsessional thoughts and acts

F423

Add

Hoarding disorder

F424

Add

Excoriation (skin-picking) disorder

F428

Add

Other obsessive compulsive disorder

F429

Add

Obsessive-compulsive disorder, unspecified

F80.82: Social pragmatic communication disorder

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Chapter 6 Nervous System

(G00 G99)
This chapter incorporates changes that include code sets for:
G56.03: Carpal tunnel syndrome, bilateral upper limbs
G57.53: Tarsal tunnel syndrome, bilateral lower limbs
Various lesions of specific nerves

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Chapter 7 Eye and Adnexa

(H00 H59)
Among the many proposed updates in the Tabular List, a large chunk
occurs in categories H54 Blindness and low vision
Many codes added the laterality as concepts that were previously
missing, such as in the diabetic retinopathy codes

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Chapter 8 Ear and Mastoid Process

(H60 H95)
Numerous additions, revisions and deletions to this chapter
including:
H90.A11: Conductive hearing loss, unilateral, right ear with restricted hearing
on the contralateral side
H90.A12: Conductive hearing loss, unilateral, left ear with restricted hearing
on the contralateral side

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Chapter 9 Circulatory System

(I00 I99)
Updates include the addition of:
Hypertensive urgency, emergency, or crisis
Reducing specificity of nontraumatic subarachnoid hemorrhage and
the communicating artery
Expansion of the cerebral infarction and sequela of stroke codes
Addition of aneurysm of precerebral and vertebral arteries
Addition of dissection of unspecified arteries

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Chapter 10 Respiratory System

(J00 J99)
Chapter 10 (Diseases of the Respiratory System) added a minimal
number of codes including:

J985

Delete

Diseases of mediastinum, not elsewhere classified

J9851

Add

Mediastinitis

J9859

Add

Other diseases of mediastinum, not elsewhere classified

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Chapter 11 Digestive System

(K00 K95)
Additions within Chapter 11 for the Digestive System:

Numerous dental conditions

Ischemia or acute infarction of the intestines
Megacolon types
More specific pancreatitis codes

Example:
K58.1: Irritable bowel syndrome with constipation

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Chapter 12 Skin and Subcutaneous Tissue

(L00 L99)
Additions to this chapter
include:
L03.213: Preorbital cellulitis
L98.7: Excessive and redundant
skin and subcutaneous tissue

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Chapter 13 Musculoskeletal and Connective

Tissue (M00 M99)
152 new codes added
Includes additional classifications for bunions, temporomandibular
joint conditions, cervical spine disorders and atypical femoral
fractures
Addition of M97.01: Periprosthetic fracture around internal prosthetic
right hip joint

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Chapter 14 Genitourinary System

(N00 N99)
Some nonspecific codes are deleted and replaced by more specific
designations
For example, N83.0: Follicular cyst of ovary, has been deleted for
2017 and replaced by the following:

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Chapter 14 Genitourinary System

(N00 N99)
Deleting, N61; Inflammatory disorders of breast
Adding
N61.0; Mastitis without abscess
N61.1; Abscess of the breast and nipple
Deleting, N90.6; Hypertrophy of vulva
Adding
N90.60; Unspecified hypertrophy of vulva
N90.61; Childhood asymmetric labium majus enlargement (CALME)
N90.69; Other specified hypertrophy of vulva
N93.1; Pre-pubertal vaginal bleeding

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Chapter 14 Genitourinary System

(N00 N99)
Deleting:

N83.0; follicular cyst of ovary

N83.1; Corpus luteum cyst
N83.20; Unspecified ovarian cyst
N83.29; Other ovarian cysts
N83.31; Acquired atrophy of ovary
N83.32; Acquired atrophy of fallopian tube
N83.33; Acquired atrophy of ovary and fallopian tube
N83.4; Prolapse and hernia of ovary and fallopian tube
N83.51; Torsion of ovary and ovarian pedicle
N83.52; Torsion of fallopian tube

Adding 5th and 6th characters identify laterality

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Chapter 15 Pregnancy, Childbirth and the

Puerperium (O00 O9A)
Deleting:
O00.0; Abdominal pregnancy
O00.1; Tubal pregnancy
O00.2; Ovarian pregnancy
O00.8; Other ectopic pregnancy
O00.9; Ectopic pregnancy, unspecified
Adding 5th character to indicate with or without intrauterine pregnancy
Revising codes O09.10-O09.13 to remove or molar
Adding O09.A0-O09.A3; Supervision of pregnancy with history of molar pregnancy
5th character specifies trimester

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Chapter 15 Pregnancy, Childbirth and the

Puerperium (O00 O9A)

Adding:
O11.4; Pre-existing hypertension with pre-eclampsia, complicating childbirth
O11.5; Pre-existing hypertension with pre-eclampsia, complicating the puerperium
O12.04; Gestational edema, complicating childbirth
O12.05; Gestational edema, complicating the puerperium
O12.14; Gestational proteinuria, complicating childbirth
O12.15; Gestational proteinuria, complicating the puerperium
O12.24; Gestational edema with proteinuria, complicating childbirth
O12.25; Gestational edema with proteinuria, complicating the puerperium
O13.4; Gestational [pregnancy-induced] hypertension without significant proteinuria, complicating
childbirth
O13.5; Gestational [pregnancy-induced] hypertension without significant proteinuria, complicating the
puerperium

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Chapter 15 Pregnancy, Childbirth and the

Puerperium (O00 O9A)
Adding:

O14.04; Mild to moderate pre-eclampsia, complicating childbirth

O14.05; Mild to moderate pre-eclampsia, complicating the puerperium
O14.14; Severe pre-eclampsia, complicating childbirth
O14.15; Severe pre-eclampsia, complicating the puerperium
O14.24; HELLP syndrome, complicating childbirth
O14.25; HELLP syndrome, complicating the puerperium
O14.94; Unspecified pre-eclampsia, complicating childbirth
O14.95; Unspecified pre-eclampsia, complicating the puerperium

Revising O15.00-O15.03;
Now reads Pre-eclampsia complicating pregnancy instead of in pregnancy

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Chapter 15 Pregnancy, Childbirth and the

Puerperium (O00 O9A)
Revising O15.1
Now reads Eclampsia complicating childbirth instead of in labor

Revising O15.2
Now reads Eclampsia complicating the puerperium instead of in the puerperium

Adding:

O16.4; Unspecified maternal hypertension, complicating childbirth

O16.5; Unspecified maternal hypertension, complicating the puerperium
O24.415; Gestational diabetes in pregnancy, controlled by oral hypoglycemic drugs
O24.425; In Childbirth
O24.435; In puerperium

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Chapter 15 Pregnancy, Childbirth and the

Puerperium (O00 O9A)
Third Degree Perineal Lacerations
Code O70.2: Third degree perineal laceration during delivery has
been expanded to identify the different degrees of third degree
lacerations that may occur:
O70.21 Third degree perineal laceration during delivery, IIIa
O70.22 Third degree perineal laceration during delivery, IIIb
O70.23 Third degree perineal laceration during delivery, IIIc

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Chapter 15 Pregnancy, Childbirth and the

Puerperium (O00 O9A)
Non-specific Placenta Previa codes revised to include Complete and NOS or without
hemorrhage and with hemorrhage:
O44.00 Complete placenta Previa NOS or without hemorrhage, unspecified trimester
O44.01 Complete placenta Previa NOS or without hemorrhage, first trimester
O44.02 Complete placenta Previa NOS or without hemorrhage, second trimester
O44.03 Complete placenta Previa NOS or without hemorrhage, third trimester
O44.10 Complete placenta Previa with hemorrhage, unspecified trimester
O44.11 Complete placenta Previa with hemorrhage, first trimester
O44.12 Complete placenta Previa with hemorrhage, second trimester
O44.13 Complete placenta Previa with hemorrhage, third trimester

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Chapter 15 Pregnancy, Childbirth and the

Puerperium (O00 O9A)
Gestational Diabetes:
New codes have been added to indicate when gestational diabetes is controlled
by oral hypoglycemic drugs, during pregnancy, childbirth or in the Puerperium:
O24.415 Gestational diabetes mellitus in pregnancy, controlled by oral
hypoglycemic drugs
O24.425 Gestational diabetes mellitus in childbirth, controlled by oral
hypoglycemic drugs
O24.435 Gestational diabetes mellitus in puerperium, controlled by oral
hypoglycemic drugs

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Chapter 15 Pregnancy, Childbirth and the

Puerperium (O00 O9A)
Previous Cesarean Section
O34.21 Maternal care for scar from previous cesarean delivery, has been
expanded into three codes to indicate the different types cesarean sections
that may be performed, as well as an unspecified code:
O34.211 Maternal care for low transverse scar from previous cesarean
delivery
O34.212 Maternal care for vertical scar from previous cesarean delivery
O34.219 Maternal care for unspecified type scar from previous cesarean
delivery

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Chapter 15 Pregnancy, Childbirth and the

Puerperium (O00 O9A)
Changes to Other Fetal Deformities
033.7: Maternal care for disproportion due to other fetal deformities
Expanded to include a 7th character of 0-5,9
To identify which fetus is affected by the deformity in cases of single or
multiple pregnancies

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Chapter 16 Perinatal Conditions

(P00 P96)
Changes:
Updates to code titles
P00.3

Revise to

Newborn affected by other maternal circulatory and respiratory diseases

P00.4

Revise from Newborn (suspected to be) affected by maternal nutritional disorders

New Codes:
P05.09: Newborn light for gestational age, greater than 2500 grams
P05.19: Newborn light for gestational age, other

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Chapter 17 Congenital Malformations,

Deformations and Chromosomal Abnormalities
(Q00 Q99)
Additions to this chapter include:
New congenital cardiac conditions
Various longitudinal vaginal septum conditions
Q252

Delete

Atresia of aorta

Q2521

Add

Interruption of aortic arch

Q2529

Add

Other atresia of aorta

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Chapter 18 Symptoms, Signs and Abnormal

Clinical and Laboratory Findings
(R00 R99)
Added codes for the following:

National Institute of Health Stroke Scale (NIHSS) scores

Microscopic hematuria
Expansion of Total Glasgow Coma Score
Cacteriuria
Abnormal radiologic findings on diagnostic imaging
Expansion of abnormal Prostate Specific Antigen (PSA)

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Chapter 19 Injuries and Poisonings

(S00 T88)
885 new codes added to this chapter
Concrete guidance on the 7th character applications
Increased site specificity for fracture codes of the following sites:

Neck,
Base of skull,
Facial bones,
Salter-Harris calcaneal fractures; and
Other fractures

Changes for concussions: S06.0X9- versus S06.0X035

Chapter 20 External Causes of Morbidity

(V00 Y99)
Updates to:
Vehicular accident codes
V47.0XXA: Car driver injured in collision with fixed or stationary object in non-traffic
accident, initial encounter

Added:
Contact with paper or sharp objects
Overexertion
Activity of the choking game

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Chapter 21 Factors Influencing Health Status

(Z00 Z99)
Clarification on the use of Wellness Z codes
Additional clarification on the aftercare Z codes
Z29.1: Encounter for prophylactic measures
Includes encounter for administration of immunoglobulin, according to the
clarifying note

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Chapter 21 Factors Influencing Health Status

(Z00 Z99)
Adding:
Z30.015; Encounter for initial prescription of Vaginal ring hormonal contraceptive
Z30.016; transdermal patch hormonal contraceptive device
Z30.017; implantable subdermal contraceptive

Z30.44; Encounter for surveillance of vaginal ring hormonal contraceptive device

Z30.45; transdermal patch hormonal contraceptive device
Z30.46; implantable subdermal contraceptive

Z31.7; Encounter for procreative management and counseling for gestational

carrier
Z33.3; Pregnant state gestational carrier

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ICD-10-PCS
FY 2017 Updates

39

ICD-10-PCS Code FY 2017 Totals, By Section

ICD-10-PCS FY 2017 Updates

Medical and Surgical

65,676

Obstetrics

300

Placement

861

Administration

1,427

Measurement and Monitoring

342

Extracorporeal Assistance and Performance

41

Extracorporeal Therapies

46

Osteopathic

100

Other Procedures

60

Chiropractic

90

Imaging

2,943

Nuclear Medicine

463

Radiation Oncology

1,939

Rehabilitation and Diagnostic Audiology

1,380

Mental Health

30

Substance Abuse Treatment

59

New Technology

41

TOTAL

75,789

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ICD-10-PCS FY 2017 Updates

Coordination and Maintenance
Committee
All PCS codes to date approved:
New, revised, and deleted
75,625 PCS Codes
3,651 new codes
487 revised code titles

Additional new codes include:

Removal and Revision of lower
joints
Expansion of the body part
detail
Unicondylar knee replacement

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ICD-10-PCS FY 2017 Updates

ICD-10-PCS Changes Highlights:
Medical and Surgical section
Root Operation definitions revised for:
Control
Creation

Extracorporeal Therapies section

New Root Operation created:
Perfusion

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Heres How It Works.

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Crosswalks

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Summary
ICD-10-CM:
1,943 New Codes

ICD-10-PCS:
3, 827 New Codes

422 Revised From Codes

491 Revised Titles

422 Revised To Codes

305 Deleted Codes

12 Deleted Codes

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References
ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD10CM/2017/NewICD10CMCodes_
FY2017.txt
https://www.cms.gov/Medicare/Coding/ICD10/Downloads/2017-Official-ICD-10-PCS-CodingGuidelines.pdf

www.cdc.gov
www.cdc.gov/nchs/icd/icd9cm_maintenance.htm
https://www.supercoder.com/icd10cm-code-changes-2017

www.cdc.gov/nchs/icd/icd9cm_maintenance.htm
www.cdc.gov/nchs/data/icd/Interim_advice_updated_final.pdf.

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