For many, fall is defined by falling leaves and lower temperatures. But for coders, the season is all about changing codes. If you’re not yet up to date on the 2019 ICD-10-CM (which took effect October 1) and you haven’t been prepping for the coming 2019 Current Procedural Terminology (CPT®) codes (which take effect January 1, 2019)—it’s time! Your practice could be missing out on some serious reimbursement.
Coding instructor Danielle Holle spends much of her 3-part series on pediatric coding guiding attendees through the key details of both old unchanged codes as well as new, tricky ones. And there’s a lot learn if you want to polish up your coding for the new year.
Focus your study: While there are pediatrics CPT® code changes for 2019 (notably, the deletion of developmental testing code 96111 and the revisions of car seat/bed testing codes 94780 and 94781), you’ll find the vast majority of pediatrics code changes in the 2019 ICD-10-CM set.
As a preview, here are some (but not all—there are too many to include here) of the new and revised codes ICD-10 codes for 2019:
Get to Know the New ‘Newborn affected by’ Codes
Be aware of these pediatrics ICD-10 code changes regarding a “Newborn affected by …”:
P35: Zika virus
- 4, Congenital Zika virus disease
P04: Maternal use of drugs
- 12, Cytotoxic drugs
- 13, Anticonvulsants
- 14, Opiates
- 15, Antidepressants
- 16, Amphetamines
- 17, Sedative-hypnotics
- 42, Hallucinogens
- 81, Cannabis
More P04: You’ll also encounter new, less specific P04 codes that include “other” or “unspecified” in their descriptions. For instance, “Newborn affected by maternal use of…”:
- 18, Other maternal medication
- 19, Unspecified medication
- 40, Unspecified drugs of addiction
- 89, Other noxious substances
Add these Chlorine Imbalance Codes to Your Toolbox
New P74 codes regarding chlorine (im)balance in newborns include:
- 42, Disturbances of chlorine balance of newborn
- 421, Hyperchloremia
- 422, Hypochloremia
Start Coding for Human Trafficking
This year there are at least 12 new codes to diagnose whether a child has been mistreated. They fall into two main categories, one for diagnosing child sexual exploitation, and the other child forced labor.
Child sexual exploitation, confirmed or suspected: New pediatrics ICD-10-CM codes dealing with sexual exploitation are for either confirmed (T74.52) or suspected (T76.52) diagnoses. Each new code will end in either -XA for initial encounter, -XD for a subsequent encounter, or -XS for sequela. For example, a subsequent encounter for suspected sexual exploitation would be coded as T76.52XD.
These codes are just one digit apart, so watch out. They’re in numerical as well as alphabetical order – T74.52 codes go with “confirmed,” while T76.52 codes go with “suspected.”
Child forced labor, confirmed or suspected: This year also sees 6 new ICD-10-CM codes for child forced labor: confirmed (T74.62) or suspected (T62.62). Like the sexual exploitation codes above, these will end in either -XA, -XD, or -XS. So, let’s say you’re coding for child forced labor, confirmed, first encounter: You would use code T74.62A.
Heed this Minor Technical Revision to Baby Stroller Codes
The revised pediatrics ICD-10 codes for 2019 deal mainly with stroller accidents (V82), but the update is very minor.
The old codes included “babystroller” as one word, whereas in the new codes the compound word has been separated. Don’t forget that these follow a pattern: -A for initial encounter, -D for subsequent encounter, and -S for sequela. The revised codes are as follows:
- 821, Fall from baby stroller
- 822, Baby stroller colliding with stationary object
- 828, Other accident with baby stroller
Don’t Fall Back into Bad Habits
The code updates outlined above are just a start. In 2019, you’ll also see a change to codes regarding developmental screenings, hypernatremia, hyponatremia, and alkalosis, just to name a few.
As always, you must be sure you’re selecting the most specific, correct diagnosis code—so you won’t risk ire from payers, notes Holle. Be sure to tune in to her webinars for tips and best practices for using all the new and revised ICD-10 pediatrics codes properly. You’ll also pick up advice on how best to integrate CPT® code changes into your billing processes for 2019.
