In the 2019 ICD-10-CM release, the Centers for Medicare & Medicaid Services (CMS) unveiled a total of 473 code changes, including 279 brand-new codes. And urology is among the top 10 specialties facing significant diagnostic coding changes for 2019.
The scoop: Most of the new urology ICD-10 codes for 2019 address urethral stricture, both male and female, according to urology coding guru Michael Ferragamo in his audioconference, “2019 ICD-10 Coding Changes for Urology.” You will also see new codes for hypocitraturia, hyperoxaluria, hyperuricosuria, and hypercalciuria.
N35: Unblock Your Confusion over Urethral Stricture Codes
ICD-10 Chapter 14 (Diseases of the Genitourinary System) has undergone significant revision, according to Meridian Medical Management. This chapter has 17 new codes related to urethral strictures to further specify anatomy.
Old way: Before the 2019 code updates, you had just a few options for coding urethral stricture:
- 0 — Post-traumatic urethral stricture
- 01 — Post-traumatic urethral stricture, male
- 11 — Postinfective urethral stricture, not elsewhere classified, male
- 8 — Other urethral stricture
- 9 — Urethral stricture, unspecified
- 11 — Postprocedural urethral stricture, male
New way: Although CMS did not delete the above codes, the 2019 ICD-10 update did add more descriptive coding options in these categories. Here are the new urology ICD-10 codes in Chapter 14:
- 016 — Post-traumatic urethral stricture, male, overlapping sites
- 116 — Postinfective urethral stricture, not elsewhere classified, male, overlapping sites
- 81 — Other urethral stricture, male
- 811 — Other urethral stricture, male, meatal
- 812 — Other urethral bulbous stricture, male
- 813 — Other membranous urethral stricture, male
- 814 — Other anterior urethral stricture, male, anterior
- 816 — Other urethral stricture, male, overlapping sites
- 819 — Other urethral stricture, male, unspecified site
- 82 — Other urethral stricture, female
- 91 — Urethral stricture, unspecified, male
- 911 — Unspecified urethral stricture, male, meatal
- 912 — Unspecified bulbous urethral stricture, male
- 913 — Unspecified membranous urethral stricture, male
- 914 — Unspecified anterior urethral stricture, male
- 916 — Unspecified urethral stricture, male, overlapping sites
- 919 — Unspecified urethral stricture, male, unspecified site
- Pinhole meatus NOS
- Urethral stricture NOS
- 92 — Unspecified urethral stricture, female
- 116 — Postprocedural urethral stricture, male, overlapping sites
Don’t Overlook Revamped Urinalysis Codes
Pay attention: Also, CMS added a handful of codes that impact urology in Chapter 18 (Symptoms, Signs, and Abnormal Clinical and Laboratory). These new ICD-10 codes fall under R82.9 — Other and unspecified abnormal findings in urine. Under R82.99 — Other abnormal findings in urine, CMS deleted “cells and casts in urine,” “crystalluria,” and “melanuria.” Then, CMS added the following new codes:
- 991 — Hypocitraturia
- 992 — Hyperoxaluria (excludes E72.53 — Primary hyperoxaluria)
- 993 — Hyperuricosuria
- 994 — Hypercalciuria
- Idiopathic hypercalciuria
- 998 — Other abnormal findings in urine
- Cells and casts in urine
- Crystalluria
- Melanuria
What’s more: CMS also added several new ICD-10 codes for abnormal testicular radiologic diagnostic testing in Chapter 18:
- 81 — Abnormal radiologic findings on diagnostic imaging of testis
- 811 — …of right testicle
- 812 — …of left testicle
- 813 — …of testicles, bilateral
- 819 — …of unspecified testicle
Before the 2019 updates, you had to rely on ICD-10 code R93.8 — Abnormal findings on diagnostic imaging of other specified body structures to describe testicular imaging. Now you can use these more descriptive codes.
Get Ready for the Oct. 1 Start Date
Remember: You can begin using the newly updated 2019 ICD-10-CM codes beginning on Oct. 1, 2018 through Sept. 30, 2019. CMS and the U.S. Centers for Disease Control and Prevention (CDC) have also released the ICD-10-CM FY 2019 Guidelines.
Bottom line: Pay special attention to these coding changes for urethral stricture, urinalysis findings, and testicular diagnostic imaging, Ferragamo stresses. But also make sure you’re up-to-date on all the ICD-10 2019 code additions, deletions, and revisions, so that you’ll be prepared for the Oct. 1 effective date. Understand what these code updates will mean for your urology coding to proactively minimize denials in the coming year.
