Three Tips to Prepare for 2017 Coding Changes for Orthopedics

Orthopedic coders may be right in claiming that they were particularly hit hard by ICD-10. In 2015, around 200 codes were introduced by ICD-10 to replace 714.0 (Rheumatoid arthritis). At that time, orthopedic coders earned some time before starting on with seven different seventh character options which could apply to fractures. Now, it is again time to be ready for the upcoming changes to orthopedic diagnoses in the 2017 ICD-10 CM code set, which will be in effect from October 1, 2016. Here are three useful hints which will guide you in providing you with a slight head start –

1. Demand Cervical Disc during Documentation

If you are concerned with cervical disc disorders, you must be aware of the change from codes which lumped “mid-cervical region” codes together. In the ICD-10 2017, you will be required to know whether C4-C5, C5-C6, or C6-C7 affected by the conditions.

For example – there will be expansion of ICD-10 2016 code M50.22 (mid-cervical region, other cervical disc displacement) to the below four codes in ICD-10 2017 –

  • 220, Other cervical disc displacement, mid-cervical region, unspecified level
  • 221, Other cervical disc displacement at C4-C5 level
  • 222, Other cervical disc displacement at C5-C6 level
  • 223, Other cervical disc displacement at C6-C7 level

2. See beyond the Codes

Code additions are not the only changes which will affect your coding documentation requirements and accuracy, even though they get a lot of attention. One can review revisions, additions and deletions in the tabular notes and index too. You could find a note which provides you with the confidence that the correct code for a diagnosis is being used by you like the addition of “compression fracture of vertebra NOS” with M48.5- (collapsed vertebra, not classified elsewhere). You could even find code changes that you might have missed otherwise, like the change in the seventh character requirement for S99 – (unspecified and other injuries of foot and ankle). Look at the subcategory’s requirement instead of using A (initial), D (subsequent), and S (Sequela) for every code in that category. Example: A note with new subcategory S99.0- (Physeal fracture of calcaneus) lists these seventh character options:

  • A, Initial encounter for closed fracture
  • B, Initial encounter for open fracture
  • D, Subsequent encounter for fracture with routine healing
  • G, Subsequent encounter for fracture with delayed healing
  • K, Subsequent encounter for fracture with nonunion
  • P, Subsequent encounter for fracture with malunion
  • S, Sequela

3. Get a concrete understanding of the term Atypical Femoral Fracture

Many people have concerns regarding the new subcategory M84.75 (Atypical femoral fracture) and are asking what exactly it is. The ICD-10 tabular does not offer much help as it does not have any instructional notes listed with subcategory besides the list of seventh character options to use. However, according to the March 2012 Summary of Diagnosis presentation from the from the Coordination and Maintenance Committee in the Orthopedic Coding Alert reports provides a hint as to what is referred to in these ICD-10 orthopedic codes. It reveals that the term “atypical fracture” is common in academic settings; however, outside of academics, it might be less popular.

With the New Year fast approaching, there is limited time left to prepare for every change that is occurring in the 2017 CPT® manual. To know more on the new physical therapy evaluation codes, new bunionectomy codes and the changes in the value of many of the Orthopedic CPT® codes, join this session on 2017 Coding Changes for Orthopedic Coding by expert speaker Margie Scalley Vaught, to go over all the changes that will affect Orthopedic Offices in 2017.

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