New ICD 10 codes for 2018 for Medical Coders


The new Year of 2018 will bring many new ICD 10 codes. We will be having around 300 new ICD 10 codes in diagnosis coding. So, for medical coders it is very important to about the new ICD 10 coding changes in 2018. So, Today I am going to share the new ICD 10 codes which are going to be added in 2018 ICD coding book.
New ICD 10 codes for 2018 for Medical Coders

Read also: Sample Coded Medical charts for Medical Coders

List of New ICD 10 codes for 2018 in Diagnosis coding


A0471 Enterocolitis due to Clostridium difficile, recurrent          
A0472 Enterocolitis due to Clostridium difficile, not specified as recurrent       
                
                
               
C9620 Malignant mast cell neoplasm, unspecified           
C9621 Aggressive systemic mastocytosis             
C9622 Mast cell sarcoma             
C9629 Other malignant mast cell neoplasm           
                
                
D4701 Cutaneous mastocytosis              
D4702 Systemic mastocytosis              
D4709 Other mast cell neoplasms of uncertain behavior         
                
                
                
E1110 Type 2 diabetes mellitus with ketoacidosis without coma        
E1111 Type 2 diabetes mellitus with ketoacidosis with coma        
                
                
E8581 Light chain (AL) amyloidosis            
E8582 Wild-type transthyretin-related (ATTR) amyloidosis            
E8589 Other amyloidosis              
                
                
F1011 Alcohol abuse, in remission            
F1111 Opioid abuse, in remission            
F1211 Cannabis abuse, in remission            
F1311 Sedative, hypnotic or anxiolytic abuse, in remission         
F1411 Cocaine abuse, in remission            
F1511 Other stimulant abuse, in remission           
F1611 Hallucinogen abuse, in remission            
F1811 Inhalant abuse, in remission            
F1911 Other psychoactive substance abuse, in remission          
F5082 Avoidant/restrictive food intake disorder            
                
                
G1223 Primary lateral sclerosis             
G1224 Familial motor neuron disease            
G1225 Progressive spinal muscle atrophy            
                
Read also: Coding tips for Antenatal Screening of Mother in ICD 10                

H442A1 Degenerative myopia with choroidal neovascularization, right          
H442A2 Degenerative myopia with choroidal neovascularization, left          
H442A3 Degenerative myopia with choroidal neovascularization, bilateral          
H442A9 Degenerative myopia with choroidal neovascularization, unspecified          
H442B1 Degenerative myopia with macular hole, right          
H442B2 Degenerative myopia with macular hole, left          
H442B3 Degenerative myopia with macular hole, bilateral          
H442B9 Degenerative myopia with macular hole, unspecified          
H442C1 Degenerative myopia with retinal detachment, right          
H442C2 Degenerative myopia with retinal detachment, left          
H442C3 Degenerative myopia with retinal detachment, bilateral          
H442C9 Degenerative myopia with retinal detachment, unspecified          
H442D1 Degenerative myopia with foveoschisis, right eye          
H442D2 Degenerative myopia with foveoschisis, left eye          
H442D3 Degenerative myopia with foveoschisis, bilateral eye          
H442D9 Degenerative myopia with foveoschisis, unspecified eye          
H442E1 Degenerative myopia with other maculopathy, right          
H442E2 Degenerative myopia with other maculopathy, left          
H442E3 Degenerative myopia with other maculopathy, bilateral          
H442E9 Degenerative myopia with other maculopathy, unspecified 

Medical Terminology Test for Medical coders

In medical coding, medical terms or terminology are very important for coding CPT and ICD 10 codes.  Even while searching codes in ICD 10 and CPT codebooks having knowledge of anatomy and physiology is very necessary. Today, we have a Medical Terminology Test to know about basic terms used in medical field. Once you go through this Medical terminology test, you will gain lot information on medical terms.

Medical Terminology Test for Medical coders



CPC Practice Exam - Medical Coding Study Guide Please Click Here!

Medical Terminology Test for Medical Coders


Cardiology -The study of the heart.

Dermatitis -Inflammation of the skin.

Pathologist-Specialist in the study of diseases.

Nephritis -Inflammation of the kidney.

Onych - The prefix pertaining to fingernail
Hidradenitis - Inflammation of a sweat gland

Spasm -Involuntary contractions.

Arthritis - Inflammation of a joint.

Dermis -Term for the skin.

Gingivitis -Inflammation of the gums.

Encephalitis -Inflammation of the brain.


Phlebitis -Inflammation of a vein.

Umbilicus - Navel; belly button.

Rhinorrhea - terms means drainage from the nose
cephal/o - refers to Head
Pyocolpos -Pus within the vagina.

Acoustic -Pertaining to hearing.

Nephrolith -Kidney stones.

Myoid -Resembling muscle.

Endocarditis -Inflammation of the inner lining of the heart.

Hypodermic -Beneath the skin.

Orthopnea - term refers to the ability to breathe comfortably only when in an upright position?
Gynecomastia - the term for abnormally large breasts in men
Hematology -Study of the blood.

Lithiasis - Abnormal condition of stones
Menarche - Beginning of menstruation
Cyanosis -Abnormal blue color to the mucous membranes of the body.
Microscope -Instrument used to observe microscopic organisms.

Gastralgia- Stomach pain.

Hysterectomy -Surgical removal of the uterus.

Hemolysis -Breaking down and dissolving of red blood cells.

Leukopenia - the term for an abnormally low white blood cell count?
An Infarct -  An area of dead myocardial tissue
Osteoma -Tumor composed of bone tissue.

Lipemic -Abnormal amount of fat in the blood.

Paralysis -The loss of movement in a part of the body.

Cystotomy -Surgical incision of the urinary bladder.

Cervical -Pertaining to the neck.

Hypertension -High blood pressure.



Sample Coded Medical Coding Charts for Practice

Report 1

REASON FOR STUDY: Left testicular pain

CLINICAL HISTORY: Pain

COMPARISON: None.

TECHNIQUE:
This study was performed in an ACR accredited facility. A sonogram of the 
scrotal sac was performed utilizing gray-scale, color, and pulsed Doppler flow.

Sample Coded Medical Coding Charts for Practice


FINDINGS:
Right Hemiscrotum: The testicle is normal in size and echotexture. The
epididymis appears normal. There is no hydrocele or varicocele. Doppler
evaluation shows normal arterial and venous flow.
Left Hemiscrotum: The testicle is normal in size and echotexture. The
epididymis appears normal. There is no hydrocele or varicocele. Doppler
evaluation shows normal arterial and venous flow.

IMPRESSION:
1. Normal testicular sonogram. No evidence of mass, inflammation, or torsion


CPT- 93976
768707
ICD – N50.82





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Report 2

REASON FOR STUDY: ABDOMINAL PAIN GENERALIZED

CLINICAL HISTORY: Abdominal pain.


COMPARISON: None.

TECHNIQUE:
The study was performed in an ACR accredited facility. Multiple transverse and
longitudinal views of the abdomen were obtained.

FINDINGS:
Liver: Normal in size and echotexture.
Spleen: Unremarkable.
Gallbladder: Echo-free without evidence of gallstones or sludge.
Biliary ducts: No evidence of biliary dilatation. The common bile duct
measures 2 mm.
Kidneys: No masses or hydronephrosis.
Pancreas: Unremarkable.
Free fluid: None.
Aorta: Unremarkable.
Inferior vena cava: Unremarkable.

IMPRESSION:
1. Unremarkable abdominal sonogram.

CPT- 76700
ICD – R10.84 Generalized abdominal pain


Report 3

REASON FOR STUDY: CONGENITAL HYDRONEPHROSIS

CLINICAL HISTORY: Hydronephrosis

COMPARISON: None.

TECHNIQUE:
The study was performed in an ACR accredited facility. Multiple transverse and
longitudinal sonographic images of the kidneys and urinary bladder were
performed.

FINDINGS:
Renal Echogenicity: The kidneys demonstrate normal renal echotexture
bilaterally without evidence for renal mass.
Pelvic Collecting System: Normal fullness in the renal collecting systems
is noted bilaterally unchanged since prior exam.
Renal Size: The right kidney measures 6.1 cm. The left kidney measures 6.
8 cm.
Bladder: The urinary bladder is unremarkable.


IMPRESSION:
1. Persistent minimal fullness of the intrarenal collecting system.


CPT -76770
ICD 10 - N13.30 Unspecified hydronephrosis


Report 4

REASON FOR STUDY: GROWTH EVALUATION

CLINICAL HISTORY: Gross evaluation

COMPARISON: None.

TECHNIQUE: Single view of the left hand was obtained

FINDINGS:
The patient's chronologic age is 8 years 4 months. Standard deviation at this
age is 8.8 months. The patient's skeletal age most closely approximates that
of the male standard #15 skeletal age 6 years.

IMPRESSION:
1. Patient's skeletal age is greater than 2 standard deviations below
chronologic age.

CPT - 77072
ICD 10 -R62.50


Coding tips for Antenatal Screening of Mother in ICD 10


Screening codes have to be used very carefully. If you really want to be perfect in ICD 10 coding, you need to use Encounter codes carefully. Always use Encounter codes as primary diagnosis. We all know that pregnancy codes are very specific in ICD 10. Even for coding weeks of gestation, we have separate Z3A category codes in ICD 10. We have already learnt about normal and outcome of delivery codes in pregnancy previously.Today we will check the use of coding Screening codes for mother.
 Coding tips for Antenatal Screening of Mother in ICD 10





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Sample chart for antenatal screening of Mother
Below I have shared an antenatal screening procedure chart for mother. Earlier we have already seen coding of normal pregnancy ICD 10 codes. By reading below chart, you can easily understand when we should report Z36, encounter for antenatal screening of Mother. Also, you can go through the CPT or procedure code 76805

REASON FOR STUDY: encounter for antenatal screening of mother z36 


CLINICAL HISTORY: Antenatal screening 


COMPARISON: None. 


TECHNIQUE: The study was performed in an ACR accredited facility. 


FINDINGS:
A single living fetus is identified. 


Fetal Position: Oblique head and left lower quadrant 

Placenta: Posterior, no previa 
Amniotic Fluid: Normal 
Cervix: 2.4 cm in length 
Uterus and Adnexa: Unremarkable 



BIOMETRIC DATA: 

Biparietal Diameter: Sonographic Age: 19 weeks, 3 days 
Head Circumference: Sonographic Age: 18 weeks, 6 days 
Abdominal Circumference: Sonographic Age: 18 weeks, 4 days 
Femur Length: Sonographic Age: 15 weeks, 3 days 



Composite Sonographic Age: 18 weeks, 6 days, for a sonographic EDD of October 

28, 2017. 



Estimated Fetal Weight: 247 grams +/- 37 grams 



The age by last menstrual period or provided adjusted EDD is weeks, days giving 

an associated EDD of . 



Fetal Anatomy: 

Cerebral Ventricles: Unremarkable 
Cavum Septum Pellucidum: Unremarkable 
Posterior Fossa: Unremarkable 
Four Chamber Heart: Unremarkable 
Ventricular outflow tracts: Unremarkable 
Three vessel View: Unremarkable 
Spine: Unremarkable 
Stomach: Unremarkable 
Renal Region: Unremarkable 
Urinary Bladder: Unremarkable 
Face and Lips: Unremarkable 
Umbilical Cord: 3 Vessel, Unremarkable 
Abdominal Wall: Unremarkable 
Extremities: Unremarkable 



ADDITIONAL COMMENTS (if any): 

None. 



IMPRESSION:
1. Single living fetus with composite sonographic age of 18 weeks, 6 days. 
Age by last menstrual period is 18 weeks, 6 days. Estimated fetal weight is 
247 grams. 



CPT code: 76805
ICD 10- Z36 – Encounter for antenatal Screening of Mother

Rationale- Since the procedure was performed on second trimester (18 weeks) the CPT code 76805 is reported. Here, pregnancy CPT codes should be coded carefully, since we have separate CPT code for detailed examination of fetus as well (76811- routine fetal ultrasound which includes all of the components (CPT code 76805), plus a detailed fetal anatomical survey)

For ICD 10 codes, since the reason for encounter is antenatal screening of mother, Z36 should be reported.

When Should I use 59 modifier in Surgery?: 3 Common Scenarios

CCI edits can create a lot of problem if you miss to bypass the procedure  using a modifier. In such situation the billing for the procedure codes will be affected. We know that the coding guidelines should be followed throughout the medical coding facilities. The use of modifier should be done very intelligently. Yes, some modifiers are really tricky to use but with experience, you will become familiar with these modifiers. Now, coming to the topic I am just gonna share few cases where the coders face CCI edits very frequently. Use of 59 or X{EPSU} modifier should be done very carefully in these cases.

3 common CCI edits Medical Coders Face


First case

In interventional radiology, their is lot of use of CPT codes. The procedures sometimes start as diagnostic and ends with a therapeutic procedure. So, here if a Fine Needle aspiration is performed and along with a core biopsy on same lesion, we can only code a core biopsy CPT code. Since, the exam is same lesion, FNA will get included in the core biopsy. Now, when both FNA and core biopsy are performed on different lesion, the FNA need to be reported with 59 or X modifier along with core biopsy. Now, you can understand how CCI edits should be used for using 59 modifiers. Even the anatomic site is important for use the modifiers. Also in some exceptional case, the physician sometimes performs core biopsy and then again perform a FNA on same lesion if he or she is not satisfied with core biopsy result. In this scenario we can use the  59 or X modifier along with FNA procedure code. This is the major confusion among surgery coders.

Read also: Best tips for Using Modifier 25 and 27




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Second Case

Now, for coding Vascular procedures in interventional radiology, you will come across for coding same CPT code again and again. For example, if you are coding selective catheterization through separate access, you might have to use same CPT code, like 36245 and 36245-59 for first order arteries. It is very common in Selective and Non-Selective Catheterization procedures. Also, if you are coding different order as well with two separate access, you have code the lower first order (36245) with 59 modifier along with first second arteries 36246. For same access procedures  the highest order 36247 includes the lower order 36246 and 36245 procedure code.


Third case

This is quite simple and still many medical coders does errors in that. For coding guidance in multiple surgery procedures, the CPT codes comes under CCI edits. For example, if you code a breast biopsy procedure with ultrasound guidance along with a liver biopsy exam performed under guidance. Now, here the breast biopsy procedure code includes the ultrasound guidance code 76942, hence it should not be reported. But, if you see the Liver biopsy has been done on same day with ultrasound guidance. Now, when you code breast biopsy, liver biopsy and ultrasound guidance together, you will definitely get a CCI edit mentioning that the ultrasound guidance is present in breast biopsy. Now, here you to add 59 modifier to 76942 cpt code, to show that this guidance is performed for liver biopsy which need to be billed separately. If you do not add the 59 modifier, the payer will not pay for the guidance, since they will assume that it is included in breast biopsy. Hence, it is really important to use modifier correctly using CCI edit tools.