2020 ICD-10-CM Code Updates – Fracture of Orbit & ADA Deficiency

CMS has added 273 new codes, revised 30 codes, and deleted 21 codes. Understand ICD-10 code changes for fracture of orbit & ada deficiency.


ICD-10-CM Code Updates for 2020: How Specific Can You Get?

By Andrea Bonner, COPC

If you haven’t taken a look at the updates, now is the time. Chances are, you’ll be impacted by the code changes no matter your specialty. Fail to follow suit, and you’ll miss out on revenue, subjecting your practice to increased claims denials and lost staff productivity. Fortunately, we’ve got the scoop on the most recent ICD-10-CM code updates:

For Clean Claims, Code for Highest Specificity

Overall, CMS has added 273 new codes, revised 30 codes, and deleted 21 codes. Many of these deletions were replaced with corresponding additions that continue the trend of increasing code specificity. For example:

D813 (Adenosine deaminase [ADA] deficiency) was deleted, while the following four codes were added:

  • D8130 Adenosine deaminase deficiency, unspecified
  • D8131 Severe combined immunodeficiency due to adenosine deaminase deficiency
  • D8132 Adenosine deaminase 2 deficiency
  • D8139 Other adenosine deaminase deficiency


Reminder: Avoid using “other” or “unspecified” codes unless there is absolutely no other code that fits. Coding to the highest level of specificity is the best practice for clean claims.

Continuing with the increased focus on specificity, Chapter 12 (Diseases of the Skin and Subcutaneous Tissue) gains 25 new codes for pressure-induced deep tissue damage. These include codes:

  • L890- 06, 16, 26
  • L891- 06,16,26,36,46,56
  • L892- 06, 16, 26
  • L893- 06, 16, 26
  • L8946
  • L895- 06, 16, 26,
  • L896- 06, 16, 26,
  • L898- 16, 96
  • L8996

In Chapter 17 (Congenital Malformations, Deformations, and Chromosomal Abnormalities), 30 new codes have been added, also to report increased specificity. For example, CMS has deleted code Q6622 (metatarsus adductus) and replaced it with:

·         Q66221 Congenital metatarsus adductus, right foot

·         Q66222 Congenital metatarsus adductus, left foot

·         Q66229 Congenital metatarsus adductus, unspecified foot


Focus on 7th Digit to Manage ICD-10 Code Updates

CMS has made 60 ICD-10-CM code updates to the S codes in Chapter 19 (Injury, Poisoning, and Certain Other Consequences of External Causes), specifically to section SO2 (Fracture of Skull and Facial Bones). In this section, 60 additions appear in the following code sets:

·         S2012xx Fracture of orbital roof

·         S2083xx Fracture of medial orbital wall

·         S2084xx Fracture of lateral orbital wall

·         S2085xx Fracture of orbit, unspecified


Tip: When using an S code, you must use a secondary code from Chapter 20 (External Causes of Morbidity) to report the cause of injury.

Elsewhere in Chapter 19, CMS has updated codes in the T series relating to underdosing of psychodysleptics, multiple unspecified drugs, and parasympathomimetics, poisoning by multiple unspecified drugs, adverse effects of multiple unspecified drugs, and heatstroke/sunstroke.

Likewise in Chapter 20 (External Causes of Morbidity), over 70 new codes have been added to the Y35XXXX code sets. The new codes in chapters 19 and 20 may seem unwieldy, you can make them more manageable by realizing that the additions focus on the 7th digit:

A: Initial Encounter

B: Initial Encounter for Open Fracture

D: Subsequent Encounter

G: Subsequent encounter for fracture with delayed healing

K: Subsequent encounter for fracture with nonunion

S: Sequela


Providers and coders will have over 72,000 ICD-10-CM codes to be aware of come October 1st, 2019. Like most healthcare professionals, you don’t have time to scour the internet for ICD-10-CM code update information you can trust. Luckily, XXXXX has you covered. Join our webinar on September XX, 2019 for an in-depth, practical look at must-know code updates to help you submit clean claims that get paid fast!


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