Be Proactive to Avoid ICD-10 Rejections

Every August, CMS posts the annual ICD-10 updates with new, deleted, and revised diagnosis codes for the coming year. This year’s update contains 21 deletions, 273 additions, and 30 revisions. 

Beginning with service dates after October 1, 2019, Medicare will reject claims with any of the following deleted codes:

• D813 - Adenosine deaminase [ADA] deficiency
• H8141 - Vertigo of central origin, right ear
• H8142 - Vertigo of central origin, left ear
• H8143 - Vertigo of central origin, bilateral
• H8149 - Vertigo of central origin, unspecified ear
• I481 - Persistent atrial fibrillation
• I482 - Chronic atrial fibrillation
• Q660 - Congenital talipes equinovarus
• Q661 - Congenital talipes calcaneovarus
• Q6621 - Congenital metatarsus primus varus
• Q6622 - Congenital metatarsus adductus
• Q663 - Other congenital varus deformities of feet
• Q664 - Congenital talipes calcaneovalgus
• Q667 - Congenital pes cavus
• Q669 - Congenital deformity of feet, unspecified
• Q796 - Ehlers-Danlos syndrome
• Q871 - Congenital malformation syndromes predominantly associated with short stature
• R828 - Abnormal findings on cytological and histological examination of urine
• T670XX - A Heatstroke and sunstroke, initial encounter
• T670XX - D Heatstroke and sunstroke, subsequent encounter
• T670XX - S Heatstroke and sunstroke, sequela

To review the complete list of all changes, suppliers can go to the CMS 2020 ICD-10 CM webpage and download the file labeled 2020 Code Descriptions in Tabular Order. This file will contain multiple documents. The “icd10cm_codes_addenda_2020” shows all additions, deletions, and revisions in alphabetical order by diagnosis code.

Suppliers are permitted to modify diagnoses for billing purposes without physician approval as long as the diagnosis is supported in the medical records. Suppliers should:

• Export active and recurring orders with linked diagnosis codes.
• Query matches to deleted codes.
• Update affected orders and patient accounts with the most appropriate new code.

Our advice? B3PR0ACT1V3*

*If there was an ICD-10 code for “be proactive”, and there probably is, that should be it.

SOURCE LINKS
https://www.cms.gov/Medicare/Coding/ICD10/2020-ICD-10-CM.html