| Surgical wound infection codes set to expand dramatically in FY2019 Home health coders could have 435 ICD-10-CM code changes to deal with starting Oct. 1, with 247 new codes, 139 revised codes, and 49 codes rendered invalid, according to the proposed hospital inpatient prospective payment system rule (IPPS) rule released April 24. One notable code, T81.4xxA (Infection following a procedure, initial encounter) could become invalid in the new code year. That’s because T81.4xxA, which is the code assigned to capture active treatment provided to a surgical wound infection, is among 49 codes proposed for deletion from the code set, according to the rule. Other seventh character options for T81.4- (T81.4xxD, Infection following a procedure, subsequent encounter and T81.4xxS, Infection following a procedure, sequela) are also being proposed for deletion. In their place, 15 new codes for postprocedural infections are proposed to be added to an expanded T81.4- subcategory, adding specificity regarding the location and depth of the infection. You’ll be able to specify that an infected surgical wound is affecting the superficial incisional surgical site (T81.41-), the deep incisional surgical site (T81.42-) and the organ and space surgical site (T81.43-). Other surgical site and unspecified options are also available (T81.49- and T81.40-). Each of these codes requires a seventh character: “A,” “D” or “S.” Additionally, three new codes are proposed to uniquely capture postprocedural sepsis, T81.44- (Sepsis following a procedure), with seventh character options “A,” “D” or “S.” Currently, postprocedural sepsis is coded to the same code for an infected surgical wound, T81.4-, according to the alphabetic index. There were no new codes proposed for non-healing surgical and trauma wounds and pathological fracture of the ribs and pelvis due to osteoporosis, which have been requested by the Association of Home Care Coding and Compliance (AHCC) and DecisionHealth and discussed at past meetings of the ICD-10 Coordination and Maintenance Committee. In addition to new codes for infected surgical wounds and postprocedural sepsis, here a few other noteworthy additions, revisions and deletions: - Neoplasms open up with 45 new codes to report carcinomas, malignant and benign neoplasms and melanocytic nevii of the eyelids under the proposed code set. In general, the new codes split 20 eyelid codes to specify upper or lower lid. However, squamous cell carcinoma of skin of left eyelid, including canthus (C44.129) will also be divided into squamous cell and sebaceous cell carcinoma.
- Eye conditions were majorly expanded with 43 new codes, including codes for right (H57.811), left (H57.812) and bilateral brow ptosis (H57.813), and right (H10.821), left (H10.822), bilateral (H10.823) and unspecified (H10.829) rosacea conjunctivitis.
- Four new codes are proposed to be added to Chapter 9 (Diseases of the circulatory system) to cover forms of cerebrovascular disease, including I63.89 (Other cerebral infarction) and I67.850 (Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy).
- Myalgia codes are set to expand from one to four, with the deletion of M79.1 (Myalgia) and the addition of four new ones for myalgia affecting the mastication muscle (M79.11), the auxiliary muscles of the head and neck (M79.12), and other specified site (M79.18) and an unspecified site (M79.10)
Editor’s note: View the proposed ICD-10-CM code change tables (6A, 6C, 6E) here. For additional coverage, stay tuned to your DecisionHealth publication.
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