ICD-10-CM updates for 2021, effective Oct. 1, 2020

The Centers for Medicare & Medicaid Services (CMS) and National Center for Health Statistics (NCHS) have published a list of proposed ICD-10-CM codes, effective Oct. 1, 2020, to Sept. 30, 2021, including 490 code additions, 47 revisions and 58 deletions. Among those major updates:

• 128 additions to Chapter 19: Injury, poisoning and certain other consequences of external causes (S00-T88) specifies fentanyl and tramadol and other synthetic narcotics.
• 125 additions to Chapter 20: External causes of morbidity (V00-Y99), now specifies accidental collisions involving electric scooters and other nonmotor vehicle accidents.
• 57 musculoskeletal codes include laterality and specificity, especially codes involved with joint derangements (M24.-)
• 21 codes to describe withdrawal from substances including alcohol (F10), cocaine and opioids (F19).
• 18 codes further detailing sickle cell anemia. New codes include:
  • D57.213 (sickle-cell/Hb-C disease with cerebral vascular involvement)
  • D57.431 (sickle-cell thalassemia beta zero with acute chest syndrome) specify complications related to the condition.
• Three codes representing chronic kidney disease (CKD), stage 3 further broken down into sub-stages: 
  • N18.30 (CKD, stage 3 unspecified)            
  • N18.31 (CKD, stage 3a)  
  • N18.32 (CKD, stage 3b)
• Deleted codes include:
  • Q51.20 — other doubling of uterus, unspecified
  • T40.4X — poisoning, underdosing, and adverse effects of other synthetic narcotics
• Revisions apply to codes:
  • Z68 — Body mass index (BMI)
  • Z88 — Allergy status codes
• There is a new Chapter 22: Codes for Special Purposes (U00-U85) with two codes: U07.0 (vaping-related disorder) and U07.1 (COVID-19).

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