It’s that time of year again! You know, the time when you have had an amazing summer, you feel refreshed and ready to get back to the coding and billing quagmire, to just be faced with the dreaded October 1st diagnosis coding update. If you are like most, we just became comfortable with the 2017 update of ICD-10 codes and finally have our clinical documentation in order. Well ICD-10 for 2018 is no different. This year we are faced with 363 NEW codes, 142 DELETED codes, and 250 REVISED codes. Many people refer to the proposed ICD-10 coding changes that is released at the beginning of the new year and assume those will be the changes that come forth in the final draft. This year that is not the case, in fact most of the revised codes and many of the deleted codes were not in the proposed code set. With that said it is important to refer to the final update posted by the Centers for Medicare and Medicaid Services on June 13, 2017. You can find that update HERE!

After reviewing all the diagnosis coding changes for 2018 I found that it spans several specialties. However, there were major changes that really stood out to me. Myocardial Infarction (MI) codes were added — now clinical documentation must state what type of MI the patient had and the code is to be selected based on that type. Several new codes were added for heart failure adding additional detail to the exact type of heart failure the patient has. For 2018, gynecologists will now be able to code for the specific antenatal screening test administered to their patients using 17 new Z codes. Considering the opioid addiction crisis changes were seen in this area — new codes were added to describe substance abuse remission. Diabetes and Neoplasms also had several coding changes for 2018. In regard to deleted codes — several codes for anorectal abscesses were deleted, along with several codes in the head injury section. Thumb subluxation and dislocation also underwent several code deletions.

Remember, it is not enough to just know the new codes — clinical documentation must also be updated to ensure the documentation in the medical record supports the diagnosis code billed. Since ICD-10 codes are so specific, and since it is imperative to choose the most specific ICD-10 code to ensure maximum reimbursement, clinical documentation must also reflect this level of clinical detail. Most times providers get in the habit of “just documenting enough” — it will be critical to find which codes will affect your providers and train them on what is expected to be documented in the medical record.

With all of this in mind HRS is here to help our clients to understand the ICD-10 coding changes and also to assist with clinical documentation tips to ensure compliance and maximum reimbursement. Visit or Call 305-576-9999 to speak to a representative on how we can help your practice to grow your revenue and stay compliant. As always, all our services are free to all clients.
Until Next Time……..

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