2019 brought a slew of new ICD-10-CM codes. The good news is that, according to the ICD10 Monitor, the number of new diagnosis codes introduced each year seems to be slowing down. There are a total of 279 new and 143 revised codes this year, and 51 have been removed.
While there are some changes specific to OB/GYNs, there are also several important, more general changes that gynecologists need to be aware of. Keeping up with coding updates ensures that physicians are documenting correctly, billing correctly and being reimbursed appropriately for the range of services they provide. Organizations such as the American College of Obstetricians and Gynecologists (ACOG) publish regularly on ICD-10 codes relevant to practitioners in this specialty, but physicians need to be aware of other types of code changes that can affect their practices and may improve their patients' health and safety.
Here are five important ICD-10-CM code changes for gynecologists to note.
1. T81.4: Post-Operative Infections
This section has been expanded and modified to allow greater detail in reporting post-operative infections. Eighteen new codes have been assigned for infections or sepsis for different types of surgical procedures, and the coding system now separates visits into initial, follow-up or for sequela. For example, the code T81.43XD is specific for an infection following a procedure, at an organ and space surgical site and in a subsequent encounter.
2. Z20.821: Exposure to Zika Virus
The Centers for Disease Control and Prevention (CDC) reports that Zika cases in the United States have decreased substantially since the initial outbreaks around 2015. However, women who are pregnant or looking to become pregnant may need to be screened if they travel to tropical locations like Puerto Rico or the Virgin Islands, where the virus is more common.
This code should be used if exposure is suspected but results are not yet available or were negative, or if the exposure was confirmed but test results were negative.
3. Z04.8, T74, T76, Z62, Z91: Sexual or Labor Exploitation
These new codes allow a physician to specify that an exam was performed for suspected or confirmed sexual or labor exploitation, and is specific about which visit (initial, subsequent or sequela). Codes Z62 and Z91 allow for documentation of a history of abuse or trafficking in childhood or adulthood.
These new codes are in response to the American Hospital Association's Hospitals Against Violence initiative against human trafficking. They allow not only for better tracking of this public health problem, but also help identify women who have been victims of trafficking in the past and might be vulnerable to exploitation in the future.
4. Z13.3: Screening for Depression or Other Mental Health Conditions
Rather than having one broad category for depression screening, this code's subcategories allow the physician to differentiate between screening for depression, maternal depression and nonspecific mental health or behavioral concerns. Z13.3 is not a reimbursable ICD-10-CM code on its own, and requires an additional character to become billable.
5. R82.99: Abnormal Urine Findings
This code has been expanded to cover specific urine test results such as hypocitraturia, hyperoxaluria, hyperuricosuria and hypercalciuria, all of which may be indicative of broader health problems. The R82.99 code may no longer be used on its own, and requires additional details to be reimbursable.
Many women — more than half — do not see a doctor other than their OB/GYN. This means that a routine annual visit may require more testing, imaging and discussion than if these patients were also seeing a primary care provider. Remaining diligent about medical coding ensures that your practice is reimbursed adequately and is complying with federal guidelines, and allows your patients to receive the best possible care at every visit.
