Coding, reimbursement, and healthcare economics are vital to the successful practice of gynecologic oncology. Below are useful resources to help you navigate best practices for coding, billing, and more including Coding Corner articles, Coding Q & A by category, information on how to get additional answers to coding questions, and SGO ConnectEd e-learning opportunities.
CODING CORNER: 2023 ICD-10-CM UPDATES | KARIN SHIH, MD
The 2023 ICD-10-CM updates include 1,176 new codes, 28 revised, and 287 deleted codes that became effective October 1, 2022. As a follow up to last month’s “Coding Corner” on new codes for social determinants of health, following is an overview of several other changes that are applicable to gynecologic oncology practice.
The ICD-10 code for acidosis E87.2 was modified to delete inclusion terms. In addition, a new code of E87.20 acidosis unspecified was added which includes metabolic acidosis NOS and lactic acidosis NOS.
As the prevalence of dementia increases in the population, the resulting sequelae impact clinical care. There are 87 new codes surrounding mental and behavioral disorders. These capture the severity of dementia with or without associated behavioral disorders. For example, for vascular dementia, codes include F01.5 vascular dementia unspecified severity, F01.A vascular dementia mild, F01.B vascular dementia moderate, and F01.C vascular dementia severe. More specific coding includes F01.X0 without behavioral disturbance, psychotic disturbance, mood disturbance, or anxiety, F01.X1 with behavioral disturbance, F01.X2 with psychotic disturbance, F01.X3 with mood disturbance, F01.X4 with anxiety.
The coding used for endometriosis (N80) has been expanded. These codes include subcategories and codes to include uterus, ovary(ies), fallopian tube(s), pelvic peritoneum, rectovaginal septum and vagina, intestine, bladder and ureters, cardiothoracic space, abdomen, and pelvic nerves.
Long term drug therapy (Z79) is used when a patient is receiving a medication for an extended period as a prophylactic measure or treatment of a chronic condition such as malignancy. Z79.6 includes long term use of immunomodulators and immunosuppressants, Z79.6 chemotherapeutic agent, Z79.64 myelosuppressive agent, Z79.69 other immunomodulators and immunosuppressants.
A new code Z91.A describes a caregiver’s noncompliance with a patient’s medical treatment and regimen.
Where applicable, utilize these codes to improve documentation of the complexity of patient care.
Karin Shih, MD, FACOG, FACS, is a gynecologic oncologist at Hofstra Northwell School of Medicine in New Hyde Park, NY.