2017 ICD-10-CM:Updates and Challenges for

Orthopedics

Presented By:Rachel M. Kaser, BS, CPC, MHSA

AHIMA-Approved ICD-10-CM/PCS TrainerAuditor; The Coding Institute (TCI)

Course Objectives

• Recognize new, revised, deleted ICD-10-CM codes taking effect October 1, 2016 pertaining to Orthopedic practices

• Avoid setbacks to reimbursement

• Utilize expert orthopedic specific tools to accurately select codes necessary for compliance and maximum reimbursement

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ICD-10-CM Updates

• Of Note:

• The Addenda that was published in June is the complete, final list of code changes going into effect this October

• Ensure your Orthopedic practice reviews the Addenda and makes note of any and all changes!

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ICD-10-CM Updates

• Much needed ICD-10-CM changes/clarifications:

• 885 new codes added to Chapter 19 (Injuries Chapter)• Increased site specificity for fracture codes of the following sites: neck,

base of skull, facial bones, Salter-Harris calcaneal fractures, and other fractures.

• 152 new codes added to Chapter 13 (Musculoskeletal Chapter)• Additional classifications for bunions, temporomandibular joint

conditions, cervical spine disorders and atypical femoral fractures

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ICD-10-CM Updates

• Much needed ICD-10-CM changes/clarifications:

• Guidance on the 7th character applications in Chapter 19

• When aftercare Z codes are appropriate instead of injury codes as it pertains to Orthopedics

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Medical Necessity

• Ensure medical necessity is met for:

• Hip and knee replacements

• Arthoscopic femoral acetabular impingement repairs

• Knee Arthroscopies

• Pelvic ring fractures

• Hip fractures

• Femur fractures

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Seventh Characters

• You’ll apply a seventh character to these codes from the following list:

• A – initial encounter for 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

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Atypical Fractures

• Rationale:• Atypical fracture

• Fosamax fracture• May refer to an atypical fracture

• Track all such atypical femoral fractures

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Atypical Fractures

• Defining as Fosamax Fracture:• Large population of patients may be missed

• These fractures can occur in absence of taking these drugs

• Review clinical documentation to verify codes are not unspecified

• Best practice includes:• Providing ongoing clinical documentation improvement

• Providing feedback to the physician including guidance on capturing the specific data requirements

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Atypical Fracture Codes

• ICD-10: Adopt These New Atypical Fracture Diagnoses Starting October 1:• M84.750: Atypical femoral fracture, unspecified

• M84.751: Incomplete atypical femoral fracture, right leg

• M84.752: Incomplete atypical femoral fracture, left leg

• M84.753: Incomplete atypical femoral fracture, unspecified leg

• M84.754: Complete transverse atypical femoral fracture, right leg

• M84.755: Complete transverse atypical femoral fracture, left leg

• M84.756: Complete transverse atypical femoral fracture, unspecified leg

• M84.757: Complete oblique atypical femoral fracture, right leg

• M84.758: Complete oblique atypical femoral fracture, left leg

• M84.759: Complete oblique atypical femoral fracture, unspecified leg

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ICD-10-CM Updates

• FY 2017:• The new codes are M and S for Orthopedics

• Over thousands of new codes added to this specialty!

• Brand new codes for Salter-Harris fractures

• Addition of completely new, necessary codes within this specialty

• New syntax for existing codes

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https://www.supercoder.com/medical-coding-webinars/2017-icd-10-cm-updates-and-challenges-for-orthopedics?utm_source=webinar-pdf&utm_medium=icd-10-orthopedics&utm_campaign=scc-org