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ICD-10-CM Coding Changes for 2020

ICD-10-CM Coding Changes for 2020

The Centers for Medicaid and Medicare Services (CMS) has issued ICD-10-CM coding changes for the fiscal year beginning October 1, 2019 through September 30, 2020. As accurate coding is essential to quicker reimbursement, ensure that you and your staff are knowledgeable to not miscode.

Let’s breakdown the biggest takeaways for 2020 ICD-10-CM coding changes.

Number of Codes Increases

Fiscal year 2019 included 71,932 codes. The new fiscal year totals 72,184. Those changes are reflected in 273 new codes, 21 deleted codes, and 30 revised codes.

New Codes by Chapter

 Chapter No
Chapter Title
Number of new codes
3 Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) 5
8 Diseases of the ear and mastoid process (H60-H95) 1
9 Diseases of the circulatory system (I00-I99) 30
12 Diseases of the skin and subcutaneous tissue (L00-L99) 25
14 Diseases of the genitourinary system (N00-N99) 3
17 Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99) 31
18 Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)   3
19 Injury, poisoning and certain other consequences of external causes (S00-T88) 87
20 External causes of morbidity (V00-Y99) 75
21 Factors influencing health status and contact with health services (Z00-Z99) 13
273

A Deeper Dive: Looking at Specific Chapter Changes

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Chapter 9: Diseases of the circulatory system (I00-I99)

This chapter has 30 new codes, including four new atrial fibrillation ones (additionally two existing codes 148.1, 148.2 were removed).

Eight new codes were added to subcategory I80.2, Phlebitis and thrombophlebitis of other and unspecified deep vessels of lower extremities, to identify phlebitis and thrombophlebitis of the peroneal vein and calf muscle veins. Additionally, specific codes for lower extremity veins were added to subcategories 4 and 5.

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Chapter 12: Diseases of the skin and subcutaneous tissue (L00-L99)

Pressure ulcer, Category L89, was expanded with a sixth character of “6,” indicating pressure-induced deep tissue damage of various anatomic sites. This change was made as there are clinical differences between unstageable ulcers and deep tissue injuries. These new codes have also added a severity status of Complication/Comorbidity (CC).

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Chapter 17: Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)

New codes were added to category Q66, Congenital deformities of feet, offering more specificity for laterality. Further, Subcategory Q79.6, Ehlers-Danlos syndrome (EDS) inserted a fifth character to identify the most common and severe types of EDS.

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Chapter 19: Injury, poisoning and certain other consequences of external causes (S00-T88)

Subcategories were introduced related to orbital roof and individual orbital walls, often seen in facial trauma situations. Poisoning codes for multiple medicaments and heatstroke/sunstroke were added as well.

Severity Changes

The ICD-10-CM code changes for 2020 also define new severity scales as seen below:

2019 Severity Level
2020 Severity Level
No. of ICD-10 Codes
% of Total
Non CC CC 183 12.3%
CC MCC 8 5%
CC Non CC 1149 77%
MCC CC 136 9.1%
MCC Non CC/MCC 17 1.1%

As you can see, most of the changes are related to a reduction in severity level, while only a few had an increased severity level.

Other Notable Changes

Revisions were made to the codes for mid-cervical disc disorder and body mass index (BMI). The Centers for Disease Control (CDC) and the National Center for Health Statistics developed ICD-10-CM codes for outpatient coding and reporting.

Download ICD-10-CM Code Changes

We’ve created documents for each category for easy accessibility. Download them now:

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