The FY 2018 ICD-10-CM and PCS annual codeset update goes into effect October 1, 2017. Below are the key changes:
Summary of Changes
Codes | ICD-10-CM | ICD-10-PCS |
New | 360 | 3,562 |
Revised | 250+ | 1,821 |
Deleted | 142 | 646 |
ICD-10-CM
New Acute Myocardial Infarction Codes
I21.9 | MCC | Acute myocardial infarction, unspecified |
I21.A | MCC | Other type of myocardial infarction |
I21.A1 | MCC | Myocardial infarction type 2 |
I21.A9 | MCC | Other myocardial infarction type |
- Type 1 is a spontaneous MI related to ischemia from a primary coronary event (e.g., plaque rupture, thrombotic occlusion)
- Type 2 is secondary to ischemia from a supply-and-demand mismatch and is always due to another underlying condition (e.g. septic shock)
- Decrease supply (e.g. hypotension)
- Increase demand (e.g. tachycardia)
- Type 2 MI due to demand ischemia or ischemic balance is assigned to code I21.A1, MI type 2 not8, Other forms of acute ischemic heart disease
- Type 2 MI’s do not require documentation of site/artery affected
New Heart Failure Codes
I50.811 | Non-CC | Acute right heart failure |
I50.812 | Non-CC | Chronic right heart failure |
I50.813 | Non-CC | Acute on chronic right heart failure |
I50.810 | Non-CC | Unspecified right heart failure |
- Previously, right heart failure was coded to I50.9, Heart failure, unspecified
- There are new codes for acute, chronic, acute on chronic, and unspecified right heart failure
- None of these new codes are CCs
ICD-10-PCS
Index Changes
- The root operation Extraction was applied to new body systems, to specify fine needle aspiration biopsies, and to other body systems to specify non-excisional debridement of deep tissue layers, such as muscle and tendon
- A new body part value was added to uniquely identify procedures performed on the common hepatic duct (before the duct branches into the left or right hepatic duct)
- The endoscopic approach value was added to many more PCS tables
- The word greater and lesser has been removed from saphenous vein and omentum procedures
- Example:
- Revise from: 061P07Y Bypass Right Greater Saphenous Vein to Lower Vein with Autologous Tissue Substitute, Open Approach
- Revise to: 061P07Y Bypass Right Saphenous Vein to Lower Vein with Autologous Tissue Substitute, Open Approach
- Revise from: 0D5S0ZZ Destruction of Greater Omentum, Open Approach
- Revise to: 0D5U0ZZ Destruction of Omentum, Open Approach
- Laterality is no longer required for procedures on the trunk, occipital, sphenoid, and maxilla. Specificity must be upper or lower.
- Example:
- Revise from: 0M5C0ZZ Destruction of Right Trunk Bursa and Ligament, Open Approach
- Revise to: 0M5C0ZZ Destruction of Upper Spine Bursa and Ligament, Open Approach
- Revise from: 0NSR45Z Reposition Right Maxilla with External Fixation Device, Percutaneous Endoscopic Approach
- Revise to: 0NSR45Z Reposition Maxilla with External Fixation Device, Percutaneous Endoscopic Approach
- Laterality is no longer required for Rib procedures. Coders must specify how many ribs are included in the procedure. Choose from 1 or 2 ribs or 3 or more.
- Example:
- Revise from: 0P510ZZ Destruction of Right Rib, Open Approach
- Revise to: 0P510ZZ Destruction of 1 to 2 Ribs, Open Approach
- Hemodialysis codes changed for duration specificity
- Example:
- Revise from: 5A1D00Z Performance of Urinary Filtration, Single
- Revise to: 5A1D80Z Performance of Urinary Filtration, Prolonged Intermittent, 6-18 hours Per Day
- Example:
- Example:
- Example:
- Example:
References