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2017 ICD-10-CM:

Updates and Challenges for


Orthopedics
Presented By:
Rachel M. Kaser, BS, CPC, MHSA
AHIMA-Approved ICD-10-CM/PCS Trainer
Auditor; The Coding Institute (TCI)

Course Objectives
Recognize new, revised, deleted ICD-10-CM codes taking effect
October 1, 2016 pertaining to Orthopedic practices
Avoid setbacks to reimbursement
Utilize expert orthopedic specific tools to accurately select codes
necessary for compliance and maximum reimbursement

ICD-10-CM Updates
Of Note:
The Addenda that was published in June is the complete, final list
of code changes going into effect this October

Ensure your Orthopedic practice reviews the Addenda and makes


note of any and all changes!

ICD-10-CM Updates
Much needed ICD-10-CM changes/clarifications:
885 new codes added to Chapter 19 (Injuries Chapter)
Increased site specificity for fracture codes of the following sites: neck,
base of skull, facial bones, Salter-Harris calcaneal fractures, and other
fractures.

152 new codes added to Chapter 13 (Musculoskeletal Chapter)


Additional classifications for bunions, temporomandibular joint
conditions, cervical spine disorders and atypical femoral fractures

ICD-10-CM Updates
Much needed ICD-10-CM changes/clarifications:
Guidance on the 7th character applications in Chapter 19
When aftercare Z codes are appropriate instead of injury codes as
it pertains to Orthopedics

Medical Necessity
Ensure medical necessity is met for:

Hip and knee replacements


Arthoscopic femoral acetabular impingement repairs
Knee Arthroscopies
Pelvic ring fractures
Hip fractures
Femur fractures

Seventh Characters
Youll apply a seventh character to these codes from the following
list:

A initial encounter for fracture


D subsequent encounter for fracture with routine healing
G subsequent encounter for fracture with delayed healing
K subsequent encounter for fracture with nonunion
P subsequent encounter for fracture with malunion
S sequela

Atypical Fractures
Rationale:
Atypical fracture

Fosamax fracture
May refer to an atypical fracture

Track all such atypical femoral fractures

Atypical Fractures
Defining as Fosamax Fracture:
Large population of patients may be missed
These fractures can occur in absence of taking these drugs

Review clinical documentation to verify codes are not unspecified


Best practice includes:
Providing ongoing clinical documentation improvement
Providing feedback to the physician including guidance on capturing the
specific data requirements

Atypical Fracture Codes


ICD-10: Adopt These New Atypical Fracture Diagnoses Starting October 1:

M84.750:
M84.751:
M84.752:
M84.753:
M84.754:
M84.755:
M84.756:
M84.757:
M84.758:
M84.759:

Atypical femoral fracture, unspecified


Incomplete atypical femoral fracture, right leg
Incomplete atypical femoral fracture, left leg
Incomplete atypical femoral fracture, unspecified leg
Complete transverse atypical femoral fracture, right leg
Complete transverse atypical femoral fracture, left leg
Complete transverse atypical femoral fracture, unspecified leg
Complete oblique atypical femoral fracture, right leg
Complete oblique atypical femoral fracture, left leg
Complete oblique atypical femoral fracture, unspecified leg

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ICD-10-CM Updates
FY 2017:
The new codes are M and S for Orthopedics
Over thousands of new codes added to this specialty!

Brand new codes for Salter-Harris fractures


Addition of completely new, necessary codes within this specialty
New syntax for existing codes

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