News & Information

The final list of the new ICD-10- CM codes that become effective October 1, 2016 has been released. There are approximately 1600 changes to the code set, making up for the four years the ICD-10- CM codes have not had a complete update. For fiscal year (FY) 2017, updates to the 2017 ICD-10- CM gynecology codes include more detailed codes, laterality, revision of postprocedural and other complications, such as problems with genitourinary implants and prostheses.

Breast Inflammatory Disorders of the Breast

The breast inflammatory disorders have been expanded and include the following two new codes:

N61.0 Mastitis without abscess

N61.1 Abscess of the breast and nipple

Ovaries and Fallopian Tubes

For most ovary and fallopian tube codes that did not previously indicate laterality, new codes have been added for right (character of 1) and left (character of 2). The unspecified code has a character of 0 (zero) or 9. These subcategory codes are:

N83.0- Follicular cyst of ovary

N83.1- Corpus luteum cyst

N83.20- Unspecified ovarian cysts

N83.29- Other ovarian cysts

N83.31- Acquired atrophy of ovary

N83.32- Acquired atrophy of fallopian tube

N83.33- Acquired atrophy of ovary and fallopian tube

N83.4- Prolapse and hernia of ovary and fallopian tube

N83.51- Torsion of ovary and ovarian pedicle

N83.52- Torsion of fallopian tube

Vulvular Hypertrophy

Hypertrophy of the vulva, N90.6-, has been expanded to include code N90.61 Childhood asymmetric labium majus enlargement or CALME, which is a female’s outer outer labia that has become swollen or enlarged on one side because of excess tissue growth. This extra tissue mass causes one side of the labia to be larger than the other, leading to an asymmetrical appearance.

Other codes that have been added include the following two codes:

N90.60 Unspecified hypertrophy of vulva

N90.69 Other specified hypertrophy of vulva

Dyspareunia

Dyspareunia is difficult or painful sexual intercourse. Previously identified with only one code, new codes have been created, which include:

N94.10 Unspecified dyspareunia

N94.11 Superficial (introital) dyspareunia (pain upon entry)

N94.12 Deep dyspareunia

N94.19 Other specified dyspareunia

Postprocedural Complications (Genitourinary Chapter [N codes])

For postprocedural hemorrhages, hematomas, and seromas, all of which were previously reported with one code from subcategory N99.82-, has now been separated into individual codes:

N99.820 Postprocedural hemorrhage of a genitourinary system organ or structure following a genitourinary system procedure

N99.821 Postprocedural hemorrhage of a genitourinary system organ or structure following other procedure

N99.840 Postprocedural hematoma of a genitourinary system organ or structure following a genitourinary system procedure

N99.841 Postprocedural hematoma of a genitourinary system organ or structure following other procedure

N99.842 Postprocedural seroma of a genitourinary system organ or structure following a genitourinary system procedure

N99.843 Postprocedural seroma of a genitourinary system organ or structure following other procedure

Congenital Anomaly: Longitudinal vaginal septum

A longitudinal vaginal septum is a congenital anomaly where a wall of tissue running down the length of the vaginal canal, partitions the space into two vaginal passageways.

The following codes have been added to identify the different types:

Q52.120 Longitudinal vaginal septum, nonobstructing

Q52.121 Longitudinal vaginal septum, obstructing, right side

Q52.122 Longitudinal vaginal septum, obstructing, left side

Q52.123 Longitudinal vaginal septum, microperforate, right side

Q52.124 Longitudinal vaginal septum, microperforate, left side

Q52.129 Other and unspecified longitudinal vaginal septum

Genitourinary Mesh Implant and Prosthetic Device Complications

Repairs of a prolapsed uterus is sometimes performed using implanted mesh material. Previously included in codes for complications associated with other prosthetic implant materials, implanted mesh now has separate codes:

T83.728- Exposure of other implanted mesh into organ or tissue

T83.79X- Other specified complications due to other genitourinary prosthetic materials, initial encounter

The 7 th character of A (initial encounter), D (subsequent encounter), or S (sequela) is added to identify the episode of care.

For subcategory codes T83.81X- (embolism), T83.82X- (fibrosis), T83.83X - (hemorrhage), T83.84X– (pain), T83.85X– (stenosis), T83.86X– (thrombosis), terminology has been revised in the code descriptions; ‘of’ has been changed to ‘due to’.

Examples of this change are:

Previous code description:

  • T83.81XA Embolism of genitourinary prosthetic devices, implants and grafts, initial encounter

New code description:

  • T83.81XA Embolism due to genitourinary prosthetic devices, implants and grafts, initial encounter

Contraception

Codes have been added for a visit that prescribes the different types of contraception available for use. These codes are:

Z30.015 Encounter for initial prescription of vaginal ring hormonal contraceptive

Z30.016 Encounter for initial prescription of transdermal patch hormonal contraceptive device

Z30.017 Encounter for initial prescription of implantable subdermal contraceptive

Z30.44 Encounter for surveillance of vaginal ring hormonal contraceptive device

Z30.45 Encounter for surveillance of transdermal patch hormonal contraceptive device

Z30.46 Encounter for surveillance of implantable subdermal contraceptive

Gestational Carriers

New codes have been added to report when a gestational carrier, or a surrogate mother, is seen for a medical service. This is a woman who bears a child on behalf of another woman, either from her own egg fertilized by the other woman's partner, or from the implantation in her uterus of a fertilized egg from the other woman. The two new codes are:

Z31.7 Encounter for procreative management and counseling for gestational carrier

Z33.3 Pregnant state, gestational carrier

Uterine Scar

For those patients who have had a previous surgery and have a uterine scar, code Z98.891

History of uterine scar from previous surgery is reported.

For more information on the 2017 ICD-10- CM update, go to: https://www.cms.gov/Medicare/Coding/ICD10/2017-ICD- 10-CM- and-GEMs.html

Author: 
Bonnie Schreck