HANDOUT - 2018 ICD-10-CM Updates - Cathy Jennings

9/22/2017
2018 ICD-10-CM Updates

Effective October 1, 2017
Cathy Jennings, CPC, CPC-I, CEDC, CHONC

Ambulatory Coding Education & Training Manager
Disclaimer
This program is intended to be informational only. Attendees are
advised to reference payer specific provider manuals, online or
otherwise, for verification prior to making changes to their coding,
documentation and/or billing practices. Attendees are also advised to
consult their managers or compliance before making changes to
coding practices.
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Agenda
• History
• Potential Issues
• Identify code updates chapter by chapter
• Look at changes in tabular listings including instructional notes
• Review changes to coding guidelines
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History
• ICD-10 is copyrighted by the World Health Organization (WHO)
• WHO authorized adaptation of ICD-10 for use in the US to create
ICD-10-CM
• ICD-10-CM was developed following evaluation by a Technical
Advisory Panel and consultation with physician groups, clinical
coders, and others
• Updates are managed by the ICD-10 Coordination and Maintenance
Committee through a process of proposals and public meetings –
see http://www.cdc.gov/nchs/icd/icd10_maintenance.htm for more
information regarding proposing updates and public meetings
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Potential Issues
• Be aware that ICD-10 updates take effect October 1 each year
• Medicare and Commercial carriers continue to revise payment
policies
• Changing payment methodologies
• Updates to guidelines
• Codes with alpha characters in them may not appear to be in order
in the ICD-10-CM book
– For example, code category C4A appears between categories C43 and C44
• Watch for the changes in wording (revisions) to existing codes and
be careful about carrying those codes forward in the record if they
no longer apply
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Potential Issues
• With any update to the code set, instructional notes can change
throughout the code set as well. Be sure to check instructional
notes for additions, deletions, and revisions.
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2018 Updates – Chapter 1

Certain Infectious and Parasitic Diseases – A00-B99
Additions
A04.71 – Enterocolitis due to Clostridium difficile, recurrent
A04.72 – Enterocolitis due to Clostridium difficile, not specified as
recurrent
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Neoplasms – C00-D49
Revision
From C96.2 – Malignant mast cell tumor
To C96.2 – Malignant mast cell neoplasm
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Additions
C96.20 – Malignant mast cell neoplasm unspecified
C96.21 – Aggressive systemic mastocytosis
C96.22 – Mast cell sarcoma
C96.29 – Other malignant mast cell neoplasm
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Revision
From D47.0 – Histiocytic and mast cell tumors of uncertain behavior
To D47.0 – Mast cell neoplasms of uncertain behavior
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Additions
D47.01 – Cutaneous mastocytosis
D47.02 – Systemic mastocytosis
D47.09 – Other mast cell neoplasms of uncertain behavior
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Diseases of the blood and blood-forming organs and certain disorders
involving the immune mechanism – D50-D89
No deleted codes, additional codes, or revised code descriptions.
There are some changes to instructional notes on codes.
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Endocrine, nutritional and metabolic disease (E00-E89) Ketoacidosis versus Ketosis
What’s the difference?
Additions
Ketoacidosis is a life-
E11.10 – Type 2 diabetes mellitus with ketoacidosis threatening condition in which
without coma the body doesn’t make
enough insulin causing a
E11.11 – Type 2 diabetes mellitus with ketoacidosis dangerously high level of
with coma ketones and blood sugar.
Ketosis is a mild form of
ketoacidosis and is not
necessarily harmful. Ketosis
can happen during a low-
carbohydrate diet or during
fasting in an otherwise healthy
person.
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Mental, Behavioral and Neurodevelopmental disorders (F01-F99)
Additions
F10.11 – Alcohol abuse, in remission
F13.11 – Sedative, hypnotic or anxiolytic abuse, in remission
F16.11 – Hallucinogen abuse, in remission
F18.11 – Inhalant abuse, in remission
F19.11 – Other psychoactive substance abuse, in remission
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Diseases of the nervous system (G00-G99)
Additions
G12.23 – Primary lateral sclerosis
G12.24 – Familial motor neuron disease
G12.25 – Progressive spinal muscle atrophy
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Diseases of the eye and adnexa (H00-H59)
Revisions An entropion is where the
Codes under H02.0 are revised changing entropian eyelid turns inwards so that
eyelashes and skin rub against
to entropion. the eye surface.
Example:
From H02.051 – Trichiasis without entropian
right upper eyelid
To H02.051 – Trichiasis without entropion
right upper eyelid
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Additions
H44.2A1 – Degenerative myopia with choroidal neovascularization,
right eye
left eye
bilateral eye
unspecified eye
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Additions
H44.2B1 – Degenerative myopia with macular hole, right eye
H44.2B2 – Degenerative myopia with macular hole, left eye
H44.2B3 – Degenerative myopia with macular hole, bilateral eye
H44.2B9 – Degenerative myopia with macular hole, unspecified eye
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Additions
H44.2C1 – Degenerative myopia with retinal detachment, right eye
H44.2C2 – Degenerative myopia with retinal detachment, left eye
H44.2C3 – Degenerative myopia with retinal detachment, bilateral eye
H44.2C9 – Degenerative myopia with retinal detachment, unspecified
eye
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Additions
H44.2D1 – Degenerative myopia with foveoschisis, right eye
H44.2D2 – Degenerative myopia with foveoschisis, left eye
H44.2D3 – Degenerative myopia with foveoschisis, bilateral eye
H44.2D9 – Degenerative myopia with foveoschisis, unspecified eye
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Additions
H44.2E1 – Degenerative myopia with other maculopathy, right eye
H44.2E2 – Degenerative myopia with other maculopathy, left eye
H44.2E3 – Degenerative myopia with other maculopathy, bilateral eye
H44.2E9 – Degenerative myopia with other maculopathy, unspecified
eye
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Additions
H54.0X33 – Blindness right eye category 3, blindness left eye category 3
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Additions
H54.1131 – Blindness right eye category 3, low vision left eye category 1
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Additions
H54.1213 – Low vision right eye category 1, blindness left eye category 3
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Additions
H54.2X11 – Low vision right eye category 1, low vision left eye category 1
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Additions
H54.413A – Blindness right eye category 3, normal vision left eye
H54.42A3 – Blindness left eye category 3, normal vision right eye
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Additions
H54.511A – Low vision right eye category 1, normal vision left eye
H54.512A – Low vision right eye category 2, normal vision left eye
H54.52A1 – Low vision left eye category 1, normal vision right eye
H54.52A2 – Low vision left eye category 2, normal vision right eye
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Diseases of the ear and mastoid process (H60-H95)
No deleted codes, additional codes, or revised code descriptions.
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Disease of the circulatory system (I00-I99)
Additions
I21.9 – Acute myocardial infarction, unspecified
I21.A1 – Myocardial infarction type 2
I21.A9 – Other myocardial infarction type
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Additions
I27.20 – Pulmonary hypertension, unspecified
I27.21 – Secondary pulmonary arterial hypertension
I27.22 – Pulmonary hypertension due to left heart disease
I27.23 – Pulmonary hypertension due to lung disease and hypoxia
I27.24 – Chronic thromboembolic pulmonary hypertension
I27.29 – Other secondary pulmonary hypertension
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Additions
I27.83 – Eisenmenger’s syndrome
Eisenmenger's Syndrome is a
condition that affects blood flow
from the heart to the lungs in
some people with some congenital
heart defects.
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Revision
From I50.1 – Left ventricular failure
To I50.1 – Left ventricular failure, unspecified
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Additions
I50.810 – Right heart failure, unspecified
I50.811 – Acute right heart failure
I50.812 – Chronic right heart failure
I50.813 – Acute on chronic right heart failure
I50.814 – Right heart failure due to left heart failure
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Additions
I50.82 – Biventricular heart failure
I50.83 – High output heart failure
I50.84 – End stage heart failure
I50.89 – Other heart failure
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Revisions
From I63.211 – Cerebral infarction due to unspecified occlusion or stenosis of right
vertebral arteries
To I63.211 – Cerebral infarction due to unspecified occlusion or stenosis of right
vertebral artery
From I63.212 – Cerebral infarction due to unspecified occlusion or stenosis of left

vertebral arteries
To I63.212 – Cerebral infarction due to unspecified occlusion or stenosis of left
vertebral artery
From I63.22 – Cerebral infarction due to unspecified occlusion or stenosis of basilar

arteries
To I63.22 – Cerebral infarction due to unspecified occlusion or stenosis of basilar
artery
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Revisions
From I63.323 – Cerebral infarction due to thrombosis of bilateral
anterior arteries
To I63.323 – Cerebral infarction due to thrombosis of bilateral
anterior cerebral arteries
From I63.333 – Cerebral infarction due to thrombosis of bilateral

posterior arteries
To I63.333 – Cerebral infarction due to thrombosis of bilateral
posterior cerebral arteries
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Revisions
From I63.513 – Cerebral infarction due to unspecified occlusion or stenosis of bilateral
middle arteries
To I63.513 – Cerebral infarction due to unspecified occlusion or stenosis of bilateral
middle cerebral arteries

anterior arteries
anterior cerebral arteries

posterior arteries
posterior cerebral arteries
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Revisions
From I82.811 – Embolism and thrombosis of superficial veins of right lower extremities
To I82.811 – Embolism and thrombosis of superficial veins of right lower extremity
From I82.812 – Embolism and thrombosis of superficial veins of left lower extremities
To I82.812 – Embolism and thrombosis of superficial veins of left lower extremity
From I82.819 – Embolism and thrombosis of superficial veins of unspecified lower

extremities
To I82.819 – Embolism and thrombosis of superficial veins of unspecified lower
extremity
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Revisions
From I83.811 – Varicose veins of right lower extremities with pain
To I83.811 – Varicose veins of right lower extremity with pain
From I83.812 – Varicose veins of left lower extremities with pain

To I83.812 – Varicose veins of left lower extremity with pain
From I83.819 – Varicose veins of unspecified lower extremities with

pain
To I83.819 – Varicose veins of unspecified lower extremity with
pain
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Revisions
From I83.891 – Varicose veins of right lower extremities with other complications
To I83.891 – Varicose veins of right lower extremity with other complications
From I83.892 – Varicose veins of left lower extremities with other complications
To I83.892 – Varicose veins of left lower extremity with other complications
From I83.899 – Varicose veins of unspecified lower extremities with other

complications
To I83.899 – Varicose veins of unspecified lower extremity with other
complications
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Disease of the respiratory system (J00-J99)
Revisions
From J15.6 – Pneumonia due to other aerobic Gram-negative
bacteria
To J15.6 – Pneumonia due to other Gram-negative bacteria
Gram-negative bacteria
are increasingly resistant
to many antibiotics.
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Disease of the digestive system (K00-K95)
Additions
K06.010 – Localized gingival recession, unspecified
K06.011 – Localized gingival recession, minimal
K06.012 – Localized gingival recession, moderate
K06.013 – Localized gingival recession, severe
K06.020 – Generalized gingival recession, unspecified
K06.021 – Generalized gingival recession, minimal
K06.022 – Generalized gingival recession, moderate
K06.023 – Generalized gingival recession, severe
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Revision
From K56.5 – Intestinal adhesions [bands] with obstruction
(postprocedural) (postinfection)
To K56.5 - Intestinal adhesions [bands] with obstruction
(postinfection)
*This code requires further characters to be a valid code.
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Additions
K56.50 – Intestinal adhesions [bands], unspecified as to partial versus
complete obstruction
K56.51 – Intestinal adhesions [bands], with partial obstruction
K56.52 – Intestinal adhesions [bands], with complete obstruction
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Additions
K56.600 – Partial intestinal obstruction, unspecified as to cause
K56.601 – Complete intestinal obstruction, unspecified as to cause
K56.609 – Unspecified intestinal obstruction, unspecified as to partial
versus complete obstruction
K56.690 – Other partial intestinal obstruction
K56.691 – Other complete intestinal obstruction
K56.699 – Other intestinal obstruction unspecified as to partial versus
complete obstruction
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Additions
K91.30 – Postprocedural intestinal obstruction, unspecified as to
partial versus complete
K91.31 – Postprocedural partial intestinal obstruction
K91.32 – Postprocedural complete intestinal obstruction
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Disease of the skin and subcutaneous tissue (L00-L99)
Additions
L97.105 – Non-pressure chronic ulcer of unspecified thigh with muscle involvement
without evidence of necrosis
L97.106 – Non-pressure chronic ulcer of unspecified thigh with bone involvement without
evidence of necrosis
L97.108 – Non-pressure chronic ulcer of unspecified thigh with other specified severity
L97.115 – Non-pressure chronic ulcer of right thigh with muscle involvement without
L97.116 – Non-pressure chronic ulcer of right thigh with bone involvement without
L97.118 – Non-pressure chronic ulcer of right thigh with other specified severity
L97.125 – Non-pressure chronic ulcer of left thigh with muscle involvement without
L97.126 – Non-pressure chronic ulcer of left thigh with bone involvement without
L97.128 – Non-pressure chronic ulcer of left thigh with other specified severity
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Additions
L97.205 – Non-pressure chronic ulcer of unspecified calf with muscle involvement
L97.206 – Non-pressure chronic ulcer of unspecified calf with bone involvement without
L97.208 – Non-pressure chronic ulcer of unspecified calf with other specified severity
L97.215 – Non-pressure chronic ulcer of right calf with muscle involvement without
L97.216 – Non-pressure chronic ulcer of right calf with bone involvement without
L97.218 – Non-pressure chronic ulcer of right calf with other specified severity
L97.225 – Non-pressure chronic ulcer of left calf with muscle involvement without
L97.226 – Non-pressure chronic ulcer of left calf with bone involvement without evidence
of necrosis
L97.228 – Non-pressure chronic ulcer of left calf with other specified severity
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Additions
L97.305 – Non-pressure chronic ulcer of unspecified ankle with muscle involvement
L97.306 – Non-pressure chronic ulcer of unspecified ankle with bone involvement without
L97.308 – Non-pressure chronic ulcer of unspecified ankle with other specified severity
L97.315 – Non-pressure chronic ulcer of right ankle with muscle involvement without
L97.316 – Non-pressure chronic ulcer of right ankle with bone involvement without
L97.318 – Non-pressure chronic ulcer of right ankle with other specified severity
L97.325 – Non-pressure chronic ulcer of left ankle with muscle involvement without
L97.326 – Non-pressure chronic ulcer of left ankle with bone involvement without
L97.328 – Non-pressure chronic ulcer of left ankle with other specified severity
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Additions
L97.405 – Non-pressure chronic ulcer of unspecified heel and midfoot with muscle involvement
L97.406 – Non-pressure chronic ulcer of unspecified heel and midfoot with bone involvement
L97.408 – Non-pressure chronic ulcer of unspecified heel and midfoot with other specified severity
L97.415 – Non-pressure chronic ulcer of right heel and midfoot with muscle involvement without
L97.416 – Non-pressure chronic ulcer of right heel and midfoot with bone involvement without
L97.418 – Non-pressure chronic ulcer of right heel and midfoot with other specified severity
L97.425 – Non-pressure chronic ulcer of left heel and midfoot with muscle involvement without
L97.426 – Non-pressure chronic ulcer of left heel and midfoot with bone involvement without
L97.428 – Non-pressure chronic ulcer of left heel and midfoot with other specified severity
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Additions
L97.505 – Non-pressure chronic ulcer of other part of unspecified foot with muscle involvement
L97.506 – Non-pressure chronic ulcer of other part of unspecified foot with bone involvement
L97.508 – Non-pressure chronic ulcer of other part of unspecified foot with other specified severity
L97.515 – Non-pressure chronic ulcer of other part of right foot with muscle involvement without
L97.516 – Non-pressure chronic ulcer of other part of right foot with bone involvement without
L97.518 – Non-pressure chronic ulcer of other part of right foot with other specified severity
L97.525 – Non-pressure chronic ulcer of other part of left foot with muscle involvement without
L97.526 – Non-pressure chronic ulcer of other part of left foot with bone involvement without
L97.528 – Non-pressure chronic ulcer of other part of left foot with other specified severity
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Additions
L97.805 – Non-pressure chronic ulcer of other part of unspecified lower leg with muscle
involvement without evidence of necrosis
L97.806 – Non-pressure chronic ulcer of other part of unspecified lower leg with bone involvement
L97.808 – Non-pressure chronic ulcer of other part of unspecified lower leg with other specified
severity
L97.815 – Non-pressure chronic ulcer of other part of right lower leg with muscle involvement
L97.816 – Non-pressure chronic ulcer of other part of right lower leg with bone involvement without
L97.818 – Non-pressure chronic ulcer of other part of right lower leg with other specified severity
L97.825 – Non-pressure chronic ulcer of other part of left lower leg with muscle involvement without
L97.826 – Non-pressure chronic ulcer of other part of left lower leg with bone involvement without
L97.828 – Non-pressure chronic ulcer of other part of left lower leg with other specified severity
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Additions
L97.905 – Non-pressure chronic ulcer of unspecified part of unspecified lower leg with muscle
L97.906 – Non-pressure chronic ulcer of unspecified part of unspecified lower leg with bone
L97.908 – Non-pressure chronic ulcer of unspecified part of unspecified lower leg with other
specified severity
L97.915 – Non-pressure chronic ulcer of unspecified part of right lower leg with muscle involvement
L97.916 – Non-pressure chronic ulcer of unspecified part of right lower leg with bone involvement
L97.918 – Non-pressure chronic ulcer of unspecified part of right lower leg with other specified
severity
L97.925 – Non-pressure chronic ulcer of unspecified part of left lower leg with muscle involvement
L97.926 – Non-pressure chronic ulcer of unspecified part of left lower leg with bone involvement
L97.928 – Non-pressure chronic ulcer of unspecified part of left lower leg with other specified
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Additions
L98.415 – Non-pressure chronic ulcer of buttock with muscle involvement without evidence of
necrosis
L98.416 – Non-pressure chronic ulcer of buttock with bone involvement without evidence of
necrosis
L98.418 – Non-pressure chronic ulcer of buttock with other specified severity
L98.425 – Non-pressure chronic ulcer of back with muscle involvement without evidence of necrosis
L98.426 – Non-pressure chronic ulcer of back with bone involvement without evidence of necrosis
L98.428 – Non-pressure chronic ulcer of back with other specified severity
L98.495 – Non-pressure chronic ulcer of other sites with muscle involvement without evidence of
necrosis
L98.496 – Non-pressure chronic ulcer of other sites with bone involvement without evidence of
necrosis
L98.498 – Non-pressure chronic ulcer of other sites with other specified severity
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Diseases of the musculoskeletal system and connective
tissue (M00-M99)
Revisions
Change in terminology on codes M33.00-M33.19 –
changed term “dermatopolymyositis” to “dermatomyositis”.
Example
From M33.00 – Juvenile dermatopolymyositis, organ
involvement unspecified
To M33.00 – Juvenile dermatomyositis, organ
involvement unspecified
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tissue (M00-M99)
Additions
M33.93 – Dermatopolymyositis, unspecified without
myopathy
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tissue (M00-M99)
Additions
M48.061 – Spinal stenosis, lumbar region without
neurogenic claudication
M48.062 – Spinal stenosis, lumbar region with neurogenic
claudication
Neurogenic claudication is pain or
cramping in the leg usually caused by
spinal stenosis.
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Diseases of the genitourinary system (N00-N99)
Revisions
From N35.112 – Postinfective bulbous urethral stricture, not elsewhere
classified
To N35.112 – Postinfective bulbous urethral stricture, not elsewhere
classified, male
From N35.113 – Postinfective membranous urethral stricture, not elsewhere
classified
To N35.113 – Postinfective membranous urethral stricture, not elsewhere
classified, male
From N35.114 – Postinfective anterior urethral stricture, not elsewhere
classified
To N35.114 – Postinfective anterior urethral stricture, not elsewhere
classified, male
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Additions
N63.0 – Unspecified lump in unspecified breast
N63.10 – Unspecified lump in the right breast, unspecified quadrant
N63.11 – Unspecified lump in the right breast, upper outer quadrant
N63.12 – Unspecified lump in the right breast, upper inner quadrant
N63.13 – Unspecified lump in the right breast, lower outer quadrant
N63.14 – Unspecified lump in the right breast, lower inner quadrant
N63.20 – Unspecified lump in the left breast, unspecified quadrant
N63.21 – Unspecified lump in the left breast, upper outer quadrant
N63.22 – Unspecified lump in the left breast, upper inner quadrant
N63.23 – Unspecified lump in the left breast, lower outer quadrant
N63.24 – Unspecified lump in the left breast, lower inner quadrant
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Additions
N63.31 – Unspecified lump in axillary tail of the right breast
N63.32 – Unspecified lump in axillary tail of the left breast
N63.41 – Unspecified lump in right breast, subareolar
N63.42 – Unspecified lump in left breast, subareolar
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Revisions
From N99.111 – Postprocedural bulbous urethral stricture
To N99.111 – Postprocedural bulbous urethral stricture, male
From N99.112 – Postprocedural membranous urethral stricture
To N99.112 – Postprocedural membranous urethral stricture, male
From N99.113 – Postprocedural anterior bulbous urethral stricture
To N99.113 – Postprocedural anterior bulbous urethral stricture,
male
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Pregnancy, childbirth and the puerperium (O00-O9A)
Additions
O00.101 – Right tubal pregnancy without intrauterine pregnancy
O00.102 – Left tubal pregnancy without intrauterine pregnancy
O00.109 – Unspecified tubal pregnancy without intrauterine pregnancy
O00.111 – Right tubal pregnancy with intrauterine pregnancy
O00.112 – Left tubal pregnancy with intrauterine pregnancy
O00.119 – Unspecified tubal pregnancy with intrauterine pregnancy
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Additions
O00.201 – Right ovarian pregnancy without intrauterine pregnancy
O00.202 – Left ovarian pregnancy without intrauterine pregnancy
O00.209 – Unspecified ovarian pregnancy without intrauterine pregnancy
O00.211 – Right ovarian pregnancy with intrauterine pregnancy
O00.212 – Left ovarian pregnancy with intrauterine pregnancy*
O00.219 – Unspecified ovarian pregnancy with intrauterine pregnancy
*This code was published in the FY 2018 ICD-10-CM Addenda as “without”.
This was corrected in the errata released on June 27, 2017.
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Additions
O36.831 – Maternal care for abnormalities of the fetal heart rate or
rhythm, first trimester
rhythm, second trimester
rhythm, third trimester
rhythm, unspecified trimester
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Certain conditions originating in the perinatal period (P00-P96)
Additions
P29.30 – Pulmonary hypertension of newborn
P29.38 – Other persistent fetal circulation
Pulmonary hypertension of newborn,

also know as persistent pulmonary
hypertension of newborn (PPHN), is a
failure of the normal circulatory
transition that occurs after birth.
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Additions
P78.84 – Gestational alloimmune liver disease
P83.81 – Umbilical granuloma
P83.88 – Other specified conditions of integument specific to newborn
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Additions
P91.811 – Neonatal encephalopathy in diseases classified elsewhere
P91.819 – Neonatal encephalopathy, unspecified
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Congenital malformations, deformations and chromosomal
abnormalities (Q00-Q99)
Additions
Q53.111 – Unilateral intraabdominal testis
Q53.112 – Unilateral inguinal testis
Q53.211 – Bilateral intraabdominal testes
Q53.212 – Bilateral inguinal testes
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Congenital malformations, deformations and chromosomal
abnormalities (Q00-Q99)
Revision
From Q64.12 – Cloacal extrophy of urinary bladder
To Q64.12 – Cloacal exstrophy of urinary bladder
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Symptoms, signs and abnormal clinical and laboratory findings, not
elsewhere classified (R00-R99)
Addition
R06.03 – Acute respiratory distress
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Symptoms, signs and abnormal clinical and laboratory findings, not
elsewhere classified (R00-R99)
Additions
R39.83 – Unilateral non-palpable testicle
R39.84 – Bilateral non-palpable testicles
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Injury, poisoning and certain other consequences of external causes
(S00-T88)
Revisions
Change on codes S04.031-S04.049 – change term “eye” to “side”
Example
From S04.031 – Injury of optic tract and pathways, right eye
To S04.031 – Injury of optic tract and pathways, right side
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Injury, poisoning and certain other consequences of
external causes (S00-T88)
Revisions
Change on codes S62.311-S62.347 – changed a period (.)
to a comma (,)
Example
From S62.311 – Displaced fracture of base of second
metacarpal bone. left hand
To S62.311 – Displaced fracture of base of second
metacarpal bone, left hand
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(S00-T88)
Revisions
Change on codes S62.620-S62.653 – changed term “medial” to
“middle”
Example
From S62.620 – Displaced fracture of medial phalanx of right index
finger
To S62.620 – Displaced fracture of middle phalanx of right index
finger
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Injury, poisoning and certain other consequences of
external causes (S00-T88)
Revisions
Change on codes S63.121-S63.126 – removed the
term “unspecified”
Example
From S63.121 – Subluxation of unspecified
interphalangeal joint of right thumb
To S63.121 – Subluxation of interphalangeal
joint of right thumb
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(S00-T88)
Deletions
S63.131 – Subluxation of proximal interphalangeal joint of right thumb
S63.132 – Subluxation of proximal interphalangeal joint of left thumb
S63.133 – Subluxation of proximal interphalangeal joint of unspecified
thumb
S63.134 – Dislocation of proximal interphalangeal joint of right thumb
S63.135 – Dislocation of proximal interphalangeal joint of left thumb
S63.136 – Dislocation of proximal interphalangeal joint of unspecified
thumb
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(S00-T88)
Deletions
S63.141 – Subluxation of distal interphalangeal joint of right thumb
S63.142 – Subluxation of distal interphalangeal joint of left thumb
S63.143 – Subluxation of distal interphalangeal joint of unspecified
thumb
S63.144 – Dislocation of distal interphalangeal joint of right thumb
S63.145 – Dislocation of distal interphalangeal joint of left thumb
S63.146 – Dislocation of distal interphalangeal joint of unspecified
thumb
9/22/2017 78
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9/22/2017

(S00-T88)
Revisions
From S73.03 – Other anterior dislocation of hip
To S73.03 – Other anterior subluxation and dislocation of hip
From S73.04 – Central dislocation of hip
To S73.04 – Central subluxation and dislocation of hip
9/22/2017 79

(S00-T88)
Revisions
Change on codes S92.521-S92.526 – changed term “medial” to
“middle”
Example
From S92.521 – Displaced fracture of medial phalanx of right lesser
toe(s)
To S92.521 – Displaced fracture of middle phalanx of right lesser
toe(s)
9/22/2017 80
40
9/22/2017

External causes of morbidity (V00-Y99)
Additions
V86.05 – Driver of 3- or 4- wheeled all-terrain vehicle (ATV) injured in traffic accident
V86.06 – Driver of dirt bike or motor/cross bike injured in traffic accident
V86.15 – Passenger of 3- or 4- wheeled all-terrain vehicle (ATV) injured in traffic accident
V86.16 – Passenger of dirt bike or motor/cross bike injured in traffic accident
V86.25 – Person on outside of 3- or 4- wheeled all-terrain vehicle (ATV) injured in traffic
accident
V86.26 – Person on outside of dirt bike or motor/cross bike injured in traffic accident
V86.35 – Unspecified occupant of 3- or 4- wheeled all-terrain vehicle (ATV) injured in
traffic accident
V86.36 – Unspecified occupant of dirt bike or motor/cross bike injured in traffic accident
V86.45 – Person injured while boarding or alighting from a 3- or 4- wheeled all-terrain
vehicle (ATV)
V86.46 – Person injured while boarding or alighting from a dirt bike or motor/cross bike
9/22/2017 81

Additions
V86.55 – Driver of 3- or 4- wheeled all-terrain vehicle (ATV) injured in nontraffic accident
V86.56 – Driver of dirt bike or motor/cross bike injured in nontraffic accident
V86.65 – Passenger of 3- or 4- wheeled all-terrain vehicle (ATV) injured in nontraffic
accident
V86.66 – Passenger of dirt bike or motor/cross bike injured in nontraffic accident
V86.75 – Person on outside of 3- or 4- wheeled all-terrain vehicle (ATV) injured in
nontraffic accident
V86.76 – Person on outside of dirt bike or motor/cross bike injured in nontraffic accident
V86.95 – Unspecified occupant of 3- or 4- wheeled all-terrain vehicle (ATV) injured in
nontraffic accident
V86.96 – Unspecified occupant of dirt bike or motor/cross bike injured in nontraffic
accident
V86.99 – Unspecified occupant of other special all-terrain or other off-road motor vehicle
injured in nontraffic accident
9/22/2017 82
41
9/22/2017

Revision
From W29.8 – Contact with other powered powered hand tools and
household machinery
To W29.8 – Contact with other powered hand tools and
household machinery
9/22/2017 83

Factors influencing health status and contact with health services
(Z00-Z99)
Revision
From Z31.5 – Encounter for genetic counseling
To Z31.5 – Encounter for procreative genetic counseling
9/22/2017 84
42
9/22/2017

(Z00-Z99)
Additions
Z36.0 – Encounter for antenatal screening for chromosomal anomalies
Z36.1 – Encounter for antenatal screening for raised alphafetoprotein
level
Z36.2 – Encounter for other antenatal screening follow-up
Z36.3 – Encounter for antenatal screening for malformations
Z36.4 – Encounter for antenatal screening for fetal growth retardation
Z36.5 – Encounter for antenatal screening for isoimmunization
9/22/2017 85

Factors influencing health status and contact with health services (Z00-Z99)
Additions
Z36.81 – Encounter for antenatal screening for hydrops fetalis
Z36.82 – Encounter for antenatal screening for nuchal translucency
Z36.83 – Encounter for fetal screening for congenital cardiac abnormalities
Z36.84 – Encounter for antenatal screening for fetal lung maturity
Z36.85 – Encounter for antenatal screening for Streptococcus B
Z36.86 – Encounter for antenatal screening for cervical length
Z36.87 – Encounter for antenatal screening for uncertain dates
Z36.88 – Encounter for antenatal screening for fetal macrosomia
Z36.89 – Encounter for other specified antenatal screening
Z36.8A – Encounter for antenatal screening for other genetic defect
Z36.9 – Encounter for antenatal screening, unspecified
9/22/2017 86
43
9/22/2017

(Z00-Z99)
Revision
From Z40.02 – Encounter for prophylactic removal of ovary
To Z40.02 – Encounter for prophylactic removal of ovary(s)
9/22/2017 87

(Z00-Z99)
Addition
Z40.03 – Encounter for prophylactic removal of fallopian tube(s)
9/22/2017 88
44
9/22/2017

(Z00-Z99)
Revision
From Z68.1 – Body mass index (BMI) 19 or less, adult
To Z68.1 – Body mass index (BMI) 19.9 or less, adult
9/22/2017 89

(Z00-Z99)
Additions
Z71.82 – Exercise counseling
Z71.83 – Encounter for nonprocreative genetic counseling
9/22/2017 90
45
9/22/2017

(Z00-Z99)
Revision
From Z79.890 – Hormone replacement therapy (postmenopausal)
To Z79.890 – Hormone replacement therapy
9/22/2017 91

(Z00-Z99)
Additions
Z91.841 – Risk for dental caries, low
Z91.842 – Risk for dental caries, moderate
Z91.843 – Risk for dental caries, high
Z91.849 – Unspecified risk for dental caries
9/22/2017 92
46
9/22/2017
2018 Updates – Other Changes

As with most years, there are many changes to
instructional notes
Some changes are related to code additions, deletions,
and revisions
Some changes correct errors from the previous codes
set
Some changes update terminology and add consistency
to terminology
We’ll look only at the major changes to chapters and

categories.
9/22/2017 93

Revised Category Heading
From I21 ST elevation (STEMI) and non-ST elevation
(NSTEMI) myocardial infarction
To I21 Acute myocardial infarction
9/22/2017 94
47
9/22/2017

Changes to Chapter 13 Blocks
This chapter contains the following blocks
Deleted M04 Autoinflammatory syndromes
Deleted M97 Periprosthetic fracture around internal prosthetic
joint
9/22/2017 95

Deleted T20-T32 Burns and corrosions
Still Included
T20-T25 Burns and corrosions of external body surface,
specified by site
T26-T28 Burns and corrosions confined to eye and internal
organs
T30-T32 Burns and corrosions of multiple and unspecified
body regions
9/22/2017 96
48
9/22/2017

Deleted X50 Overexertion and strenuous or repetitive
movements
9/22/2017 97

Deleted Z19 Hormone sensitivity malignancy status
9/22/2017 98
49
9/22/2017

Z05 Encounter for observation and evaluation of newborn for
suspected diseases and conditions ruled out
Revision of Instructional Note for Category
From This category is to be used for newborns, within the neonatal
period (the first 28 days of life), who are suspected of having an
abnormal condition unrelated to exposure from the mother or
the birth process, but without signs or symptoms, and which,
after examination and observation, is ruled out.
To This category is to be used for newborns, within the neonatal
period (the first 28 days of life), who are suspected of having an
abnormal condition, but without signed or symptoms, and
which, after examination and observation, is ruled out.
9/22/2017 99
There are no other major instructional note changes

that affect multiple codes.
There are several minor changes to instructions notes

that affect one or a few codes.
Minor does not mean unimportant.
9/22/2017 100
50
9/22/2017
2018 Update – Coding Guidelines

The information in the following slides does not represent the entire
2018 ICD-10-CM Official Guidelines for Coding and Reporting. The
text on these slides only represents portions of guidelines that have
changed.
In addition, there were minor changes related to the code updates that
we have already covered in this presentation that I will not cover again.
For the full 2018 ICD-10-CM Official Guidelines for Coding and
Reporting, go to https://www.cdc.gov/nchs/icd/icd10cm.htm.
9/22/2017 101

Guideline I.A.15
“With”
The word “with” or “in” should be interpreted to mean “associated with” or “due to”
when it appears in a code title, the Alphabetic Index, or an instructional note in the
Tabular List. The classification presumes a causal relationship between the two
conditions linked by these terms in the Alphabetic Index or Tabular List. These
conditions should be coded as related even in the absence of provider
documentation explicitly linking them, unless the documentation clearly states the
conditions are unrelated or when another guideline exists that specifically
requires a documented linkage between two conditions (e.g., sepsis guideline
for “acute organ dysfunction that is not clearly associated with the sepsis”).
For conditions not specifically linked by these relational terms in the classification or
when a guideline requires that a linkage between two conditions be explicitly
documented, provider documentation must link the conditions in order to code them
as related.
9/22/2017 102
51
9/22/2017

Guideline I.A.17
“Code also” note
A “code also” note instructs that two codes may be required to fully
describe a condition, but this note does not provide sequencing
direction. The sequencing depends on the circumstances of the
encounter.
9/22/2017 103

Guideline I.B.7
Multiple coding for a single condition
In addition to the etiology/manifestation convention that requires two codes to fully describe a single
condition that affects multiple body systems, there are other single conditions that also require more
than one code. “Use additional code” notes are found in the Tabular List at codes that are not part
of an etiology/manifestation pair where a secondary code is useful to fully describe a condition. The
sequencing rule is the same as the etiology/manifestation pair, “use additional code” indicates that a
secondary code should be added, if known.
For example, for bacterial infections that are not included in chapter 1, a secondary code from
category B95, Streptococcus, Staphylococcus, and Enterococcus, as the cause of diseases
classified elsewhere, or B96, Other bacterial agents as the cause of diseases classified elsewhere,
may be required to identify the bacterial organism causing the infection. A “use additional code” note
will normally be found at the infectious disease code, indicating a need for the organism code to be
added as a secondary code.
“Code first” notes are also under certain codes that are not specifically manifestation codes but may
be due to an underlying cause. When there is a “code first” note and an underlying condition is
present, the underlying condition should be sequenced first, if known.
9/22/2017 104
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9/22/2017

Guideline I.C.2
Malignant neoplasm of ectopic tissue
Malignant neoplasms of ectopic tissue are to be coded to the site of
origin mentioned, e.g., ectopic pancreatic malignant neoplasms
involving the stomach are coded to malignant neoplasm of
pancreas, unspecified (C25.9).
9/22/2017 105

Guideline I.C.2.a
Treatment directed at the malignancy
If the treatment is directed at the malignancy, designate the
malignancy as the principal diagnosis.
The only exception to this guideline is if a patient admission/encounter
is solely for the administration of chemotherapy, immunotherapy or
external beam radiation therapy, assign the appropriate Z51.-- code
as the first-listed or principal diagnosis, and the diagnosis or problem
for which the service is being performed as a secondary diagnosis.
9/22/2017 106
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9/22/2017

Guideline I.C.2.e.2
Patient admission/encounter solely for administration of chemotherapy,
immunotherapy and radiation therapy
If a patient admission/encounter is solely for the administration of
chemotherapy, immunotherapy or external beam radiation therapy assign
code Z51.0, Encounter for antineoplastic radiation therapy, or Z51.11,
Encounter for antineoplastic chemotherapy, or Z51.12, Encounter for
antineoplastic immunotherapy as the first-listed or principal diagnosis. If a
patient receives more than one of these therapies during the same admission
more than one of these codes may be assigned, in any sequence.
The malignancy for which the therapy is being administered should be
assigned as a secondary diagnosis.
If a patient admission/encounter is for the insertion or implantation of
radioactive elements (e.g., brachytherapy) the appropriate code for the
malignancy is sequenced as the principal or first-listed diagnosis. Code
Z51.0
9/22/2017
should not be assigned. 107

Guideline I.C.2.e.3
Patient admitted for radiation therapy, chemotherapy or immunotherapy
and develops complications
When a patient is admitted for the purpose of external beam radiotherapy,
immunotherapy or chemotherapy and develops complications such as
uncontrolled nausea and vomiting or dehydration, the principal or first-listed
diagnosis is Z51.0, Encounter for antineoplastic radiation therapy, or Z51.11,
Encounter for antineoplastic chemotherapy, or Z51.12, Encounter for
antineoplastic immunotherapy followed by any codes for the complications.
When a patient is admitted for the purpose of insertion or implantation
of radioactive elements (e.g., brachytherapy) and develops
complications such as uncontrolled nausea and vomiting or
dehydration, the principal or first-listed diagnosis is the appropriate
code for the malignancy followed by any codes for the complications.
9/22/2017 108
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9/22/2017

Guideline I.C.4.a.3
Diabetes mellitus and the use of insulin and oral hypoglycemics
If the documentation in a medical record does not indicate the type of
diabetes but does indicate that the patient uses insulin, code E11-,
Type 2 diabetes mellitus, should be assigned. An additional code
should be assigned from category Z79 to identify the long-term
(current) use of insulin or oral hypoglycemic drugs. If the patient
is treated with both oral medications and insulin, only the code
for long-term (current) use of insulin should be assigned. Code
Z79.4 should not be assigned if insulin is given temporarily to
bring a type 2 patient’s blood sugar under control during an
encounter.
9/22/2017 109

Guideline I.C.4.a.6.a
Secondary diabetes mellitus and the use of insulin or oral
hypoglycemic drugs
For patients with secondary diabetes mellitus who routinely use
insulin or oral hypoglycemic drugs, an additional code from
category Z79 should be assigned to identify the long-term
(current) use of insulin or oral hypoglycemic drugs. If the patient
is treated with both oral medications and insulin, only the code
for long-term (current) use of insulin should be assigned. Code
Z79.4 should not be assigned if insulin is given temporarily to
bring a type 2 patient’s blood sugar under control during an
encounter.
9/22/2017 110
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9/22/2017

Guideline I.C.5.b.1
In Remission
Selection of codes for “in remission” for categories F10-F19, Mental and
behavioral disorders due to psychoactive substance use (categories F10-F19
with -11, -.21) requires the provider’s clinical judgment. The appropriate
codes for “in remission” are assigned only on the basis of provider
documentation (as defined in the Official Guidelines for Coding and
Reporting), unless otherwise instructed by the classification.
Mild substance use disorders in early or sustained remission are
classified to the appropriate codes for substance abuse in remission,
and moderate or severe substance use disorders in early or sustained
remission are classified to the appropriate codes for substance
dependence in remission.
9/22/2017 111

Guideline I.C.5.b.3
Psychoactive Substance Use Disorders
As with all other diagnoses, the codes for psychoactive substance use
disorders (F10.9-, F11.9-, F12.9-, F13.9-, F14.9-, F15.9-, F16.9-)
should only be assigned based on provider documentation and when
they meet the definition of a reportable diagnosis (see Section III,
Reporting Additional Diagnoses). The codes are to be used only when
the psychoactive substance use is associated with a physical, mental
or behavioral disorder, and such a relationship is documented by the
provider.
9/22/2017 112
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9/22/2017

Guideline I.C.7.b
Blindness
If “blindness” or “low vision” of both eyes is documented but the
visual impairment category is not documented, assign code
H54.3, Unqualified visual loss, both eyes. If “blindness” or “low
vision” in one eye is documented but the visual impairment
category is not documented, assign a code from H54.6-,
Unqualified visual loss, one eye. If “blindness” or “visual loss” is
documented without any information about whether one or both
eyes are affected, assign code H54.7, Unspecified visual loss.
9/22/2017 113

Guideline I.C.9.a.10
Pulmonary Hypertension
Pulmonary hypertension is classified to category I27, Other
pulmonary heart diseases. For secondary pulmonary
hypertension (I27.1, I27.2-), code also any associated conditions
or adverse effects of drugs or toxins. The sequencing is based on
the reason for the encounter.
9/22/2017 114
57
9/22/2017

Guideline I.C.9.e.1
Type 1 ST elevation myocardial infarction (STEMI) and non-ST
elevation myocardial infarction (NSTEMI)
The ICD-10-CM codes for type 1 acute myocardial infarction (AMI)
identify the site, such as anterolateral wall or true posterior wall.
Subcategories I21.0-I21.2 and code I21.3 are used for type 1 ST
elevation myocardial infarction (STEMI). Code I21.4, Non-ST elevation
(NSTEMI) myocardial infarction, is used for type 1 non ST elevation
myocardial infarction (NSTEMI) and nontransmural MIs.
If a type 1 NSTEMI evolves to STEMI, assign the STEMI code. If a
type 1 STEMI converts to NSTEMI due to thrombolytic therapy, it is
still coded as STEMI.
9/22/2017 115

Guideline I.C.9.e.2
Acute myocardial infarction, unspecified
Code I21.9, Acute myocardial infarction, unspecified, is the default
for unspecified acute myocardial infarction or unspecified type. If only
type 1 STEMI or transmural MI without the site is documented, assign
code I21.3, ST elevation (STEMI) myocardial infarction of
unspecified site.
9/22/2017 116
58
9/22/2017

Guideline I.C.9.e.4
Subsequent acute myocardial infarction
A code from category I22, Subsequent ST elevation (STEMI) and non-ST
elevation (NSTEMI) myocardial infarction, is to be used when a patient who
has suffered a type 1 or unspecified AMI has a new AMI within the 4 week
time frame of the initial AMI. A code from category I22 must be used in
conjunction with a code from category I21. The sequencing of the I22 and I21
codes depends on the circumstances of the encounter.
Do not assign code I22 for subsequent myocardial infarctions other
than type 1 or unspecified. For subsequent type 2 AMI assign only code
I21.A1. For subsequent type 4 or type 5 AMI, assign only code I21.A9.
9/22/2017 117

Guideline I.C.9.e.5
Other Types of Myocardial Infarction
The ICD-10-CM provides codes for different types of myocardial infarction.
Type 1 myocardial infarctions are assigned to codes I21.0-I21.4.
Type 2 myocardial infarction, and myocardial infarction due to demand
ischemia or secondary to ischemic balance, is assigned to code I21.A1,
Myocardial infarction type 2 with a code for the underlying cause. Do not
assign code I24.8, Other forms of acute ischemic heart disease for the demand
ischemia. Sequencing of type 2 AMI or the underlying cause is dependent on
the circumstances of admission. When a type 2 AMI code is described as
NSTEMI or STEMI, only assign code I21.A1. Codes I21.01-I21.4 should only be
assigned for type 1 AMIs.
Acute myocardial infarctions type 3, 4a, 4b, 4c and 5 are assigned to code
I21.A9, Other myocardial infarction type.
The "Code also" and "Code first" notes should be followed related to
complications, and for coding of postprocedural myocardial infarctions during
or following cardiac surgery.
9/22/2017 118
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9/22/2017

Guideline I.C.12.a.6
Patient admitted with pressure ulcer evolving into another stage
during the admission
If a patient is admitted to an inpatient hospital with a pressure ulcer
at one stage and it progresses to a higher stage, two separate codes
should be assigned: one code for the site and stage of the ulcer on
admission and a second code for the same ulcer site and the highest
stage reported during the stay.
9/22/2017 119

Guideline I.C.12.b
Non-Pressure Chronic Ulcers
1) Patients admitted with non-pressure ulcers documented as healed
No code is assigned if the documentation states that the non-pressure ulcer is
completely healed.
2) Patients admitted with non-pressure ulcers documented as healing
Non-pressure ulcers described as healing should be assigned the appropriate non-
pressure ulcer code based on the documentation in the medical record. If the
documentation does not provide information about the severity of the healing non-
pressure ulcer, assign the appropriate code for unspecified severity.
If the documentation is unclear as to whether the patient has a current (new) non-
pressure ulcer or if the patient is being treated for a healing non-pressure ulcer, query the
provider.
For ulcers that were present on admission but healed at the time of discharge, assign the
code for the site and severity of the non-pressure ulcer at the time of admission.
3) Patient admitted with non-pressure ulcer that progresses to another severity level during
the admission
If a patient is admitted to an inpatient hospital with a non-pressure ulcer at one severity
level and it progresses to a higher severity level, two separate codes should be assigned:
one code for the site and severity level of the ulcer on admission and a second code for120
9/22/2017
the same ulcer site and the highest severity level reported during the stay.
60
9/22/2017

Guideline I.C.13.c
7th character A is for use as long as the patient is receiving active treatment
for the fracture. While the patient may be seen by a new or different provider
over the course of treatment for a pathological fracture, assignment of the 7th
character is based on whether the patient is undergoing active treatment and
not whether the provider is seeing the patient for the first time.
7th character D is to be used for encounters after the patient has completed
active treatment for the fracture and is receiving routine care for the
fracture during the healing or recovery phase. The other 7th characters,
listed under each subcategory in the Tabular List, are to be used for
subsequent encounters for treatment of problems associated with the
healing, such as malunions, nonunions, and sequelae.
9/22/2017 121

Guideline I.C.15.q.2
Retained Products of Conception following an abortion
Subsequent encounters for retained products of conception following a
spontaneous abortion or elective termination of pregnancy, without
complications are assigned O03.4, Incomplete spontaneous,
abortion without complication, or codes O07.4, Failed attempted
termination of pregnancy without complication. This advice is
appropriate even when the patient was discharged previously with a
discharge diagnosis of complete abortion. If the patient has a
specific complication associated with the spontaneous abortion
or elective termination of pregnancy in addition to retained
products of conception, assign the appropriate complication in
category O03 or O07 instead of code O03.4 or O07.4
9/22/2017 122
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9/22/2017

Guideline I.C.15.q.3
Complications leading to abortion
Codes from Chapter 15 may be used as additional codes to identify
any documented complications of the pregnancy in conjunction with
codes in categories in O04, O07 and O08.
9/22/2017 123

Guideline I.C.18.f
Functional quadriplegia
GUIDELINE HAS BEEN DELETED EFFECTIVE OCTOBER 1, 2017
Functional quadriplegia (code R53.2) is the lack of ability to use one’s
limbs or to ambulate due to extreme debility. It is not associated with
neurologic deficit or injury, and code R53.2 should not be used for
cases of neurologic quadriplegia. It should only be assigned if
functional quadriplegia is specifically documented in the medical
record.
9/22/2017 124
62
9/22/2017

Guideline I.C.19.b
Coding of Injuries
When coding injuries, assign separate codes for each injury unless a
combination code is provided, in which case the combination code is
assigned. Codes from category T07, Unspecified multiple injuries
should not be assigned in the inpatient setting unless information for a
more specific code is not available. Traumatic injury codes (S00-
T14.9) are not to be used for normal, healing surgical wounds or to
identify complications of surgical wounds.
The code for the most serious injury, as determined by the provider
and the focus of treatment, is sequenced first.
9/22/2017 125

Guideline II.K
Admissions/Encounters for Rehabilitation
When the purpose for the admission/encounter is rehabilitation, sequence first the code
for the condition for which the service is being performed. For example, for an
admission/encounter for rehabilitation for right-sided dominant hemiplegia following a
cerebrovascular infarction, report code I69.351, Hemiplegia and hemiparesis following
cerebral infarction affecting right dominant side, as the first-listed or principal diagnosis.
If the condition for which the rehabilitation service is no longer present, report the
appropriate aftercare code as the first-listed or principal diagnosis, unless the
rehabilitation service is being provided following an injury. For rehabilitation
services following active treatment of an injury, assign the injury code with the
appropriate seventh character for subsequent encounter as the first-listed or principal
diagnosis. For example, if a patient with severe degenerative osteoarthritis of the hip,
underwent hip replacement and the current encounter/admission is for rehabilitation,
report code Z47.1, Aftercare following joint replacement surgery, as the first-listed or
principal diagnosis. If the patient requires rehabilitation post hip replacement for
right intertrochanteric femur fracture, report code S72.141D, Displaced
intertrochanteric fracture of right femur, subsequent encounter for closed fracture
with routine healing, as the first-listed or principal diagnosis.
9/22/2017 126
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9/22/2017
Cathy Jennings, CPC, CPC-I, CEDC, CHONC
Ambulatory Coding Education and Training Manager
cjennings3@kumc.edu
9/22/2017 127
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9/22/2017

2018 ICD-10-CM Updates

Cathy Jennings, CPC, CPC-I, CEDC, CHONC

2018 Updates – Chapter 1

2018 Updates – Chapter 2

2018 Updates – Chapter 2

2018 Updates – Chapter 2

2018 Updates – Chapter 2

2018 Updates – Chapter 3

No deleted codes, additional codes, or revised code descriptions.

There are some changes to instructional notes on codes.

2018 Updates – Chapter 4

2018 Updates – Chapter 5

2018 Updates – Chapter 6

2018 Updates – Chapter 7

2018 Updates – Chapter 7

2018 Updates – Chapter 7

2018 Updates – Chapter 7

2018 Updates – Chapter 7

2018 Updates – Chapter 7

2018 Updates – Chapter 7

2018 Updates – Chapter 7

2018 Updates – Chapter 7

2018 Updates – Chapter 7

2018 Updates – Chapter 7

2018 Updates – Chapter 7

2018 Updates – Chapter 7

2018 Updates – Chapter 8

No deleted codes, additional codes, or revised code descriptions.

2018 Updates – Chapter 9

2018 Updates – Chapter 9

2018 Updates – Chapter 9

2018 Updates – Chapter 9

2018 Updates – Chapter 9

2018 Updates – Chapter 9

2018 Updates – Chapter 9

From I63.212 – Cerebral infarction due to unspecified occlusion or stenosis of left

From I63.22 – Cerebral infarction due to unspecified occlusion or stenosis of basilar

2018 Updates – Chapter 9

From I63.333 – Cerebral infarction due to thrombosis of bilateral

2018 Updates – Chapter 9

From I63.523 – Cerebral infarction due to unspecified occlusion or stenosis of bilateral

From I63.533 – Cerebral infarction due to unspecified occlusion or stenosis of bilateral

2018 Updates – Chapter 9

From I82.819 – Embolism and thrombosis of superficial veins of unspecified lower

2018 Updates – Chapter 9

From I83.812 – Varicose veins of left lower extremities with pain

From I83.819 – Varicose veins of unspecified lower extremities with

2018 Updates – Chapter 9

From I83.899 – Varicose veins of unspecified lower extremities with other

2018 Updates – Chapter 10

2018 Updates – Chapter 11

2018 Updates – Chapter 11

*This code requires further characters to be a valid code.

2018 Updates – Chapter 11

2018 Updates – Chapter 11

2018 Updates – Chapter 11

2018 Updates – Chapter 12

2018 Updates – Chapter 12

2018 Updates – Chapter 12

2018 Updates – Chapter 12

2018 Updates – Chapter 12

2018 Updates – Chapter 12

2018 Updates – Chapter 12