2017 ICD-10-CM: Updates and Challenges for Orthopedics

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2017 IC
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CM
Updates and Challenges Orthopedics
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Presented By Rachel M. Kaser, BS, CPC,
MHSA AHIMA-Approved ICD-10-CM/PCS
Trainer Auditor The Coding Institute (TCI)
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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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IC
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CM Updates

Of
Note

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

Ensure your Orthopedic practice note of any and
all changes!
reviews
the
Addenda
and
makes
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IC
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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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IC
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CM Updates

Much needed ICD-10-CM changes/clarifications

7th
Guidance on the
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 Knee Arthroscopies Pelvic
ring fractures Hip fractures Femur fractures
acetabular
impingement
repairs
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Seventh Characters

Youll apply a seventh character list
to these codes from the
following

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 specific data requirements
capturing the
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Atypical Fracture Codes
ICD-10 Adopt These New Atypical Fracture
Diagnoses Starting
October
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M84.750 M84.751 M84.752 M84.753 M84.754
M84.755 M84.756 M84.757 M84.758 M84.759
Atypical femoral fracture, unspecified Incomplete
atypical femoral fracture, right leg Incomplete
atypical femoral fracture, left leg Incomplete
atypical femoral fracture, unspecified leg
Complete transverse atypical femoral fracture,
right leg Complete transverse atypical femoral
fracture, left leg Complete transverse atypical
femoral fracture, unspecified leg Complete
oblique atypical femoral fracture, right
leg Complete oblique atypical femoral fracture,
left leg Complete oblique atypical femoral
fracture, unspecified leg
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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 New syntax
for existing codes
codes
within
this
specialty
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