Prepare for 2025 ICD-10-CM Coding Updates

1
IcD 10-cm updates for 2025

• Dorothy D. SteeD
• MSLD, CCS, CDIP, COC, CPCO, CPUM, CPUR, CPHM,
  CPMA, ACS-OP, CCS-P, RCC, RMC, CEMC, CPC-I, CFPC,
  PCS, FCS, CRCR, CICA, CPAR
•  

2
Guidelines updates

• Sepsis due to a postprocedural infection For
  sepsis following a postprocedural wound (surgical
  site) infection, a code from T81.41 to T81.43,
  Infection following a procedure, T81.49,
  Infection following a procedure, other surgical
  site, or a code from O86.00 to O86.03, Infection
  of obstetric surgical wound, or code O86.09,
  Infection of obstetric surgical wound, other
  surgical site, that identifies the site of the
  infection should be sequenced first, if known.
  Assign an additional code for sepsis following a
  procedure (T81.44) or sepsis following an
  obstetrical procedure (O86.04). Use an additional
  code to identify the infectious agent. If the
  patient has severe sepsis, the appropriate code
  from subcategory R65.2 should also be assigned
  with the additional code(s) for any acute organ
  dysfunction.
• If a patient admission/encounter is chiefly for
  the administration of chemotherapy, immunotherapy
  or external beam radiation therapy assign code
  Z51.0, Encounter for antineoplastic radiation
  therapy, or Z51.11, Encounter for antineoplastic
  chemotherapy, or Z51.12, Encounter for
  antineoplastic immunotherapy as the first-listed
  or principal diagnosis.

3
Neoplasms Chapter 2

• Hodgkin Lymphomas C81x C84x
• There are multiple code clarifications that add
  in remission or not having achieved remission
• Non-Hodgkin Lymphomas C85x C86x
• There are multiple code clarifications that add
  in remission or not having achieved remission
• C88 Malignant immunoproliferative diseases and
  certain other B-cell lymphomas
• There are multiple code clarifications that add
  not having achieved remission

4
Diseases of blood blood-forming organs immune
mechanisms Chapter 3

• D61 Other aplastic anemias and other bone marrow
  failure syndromes
• D61.03 Fanconi anemia
• D89.83 Cytokine release syndrome
• Use Additional code for adverse effect, if
  applicable, to identify immune checkpoint
  inhibitors and immunostimulant drugs (T45.AX5)

5
Endocrine, nutritional metabolic diseases
chapter 4

• E08 E09 Diabetes mellitus due to underlying
  condition
• E10.A Type 1 diabetes mellitus, presymptomatic
• Additional descriptors
• Early-stage type 1 diabetes mellitus
• E10.A0 Type 1 diabetes mellitus, presymptomatic,
  unspecified
• E10.A1 Type 1 diabetes mellitus,
  presymptomatic, Stage 1
• Multiple confirmed islet autoantibodies with
  normoglycemia
• E10.A2 Type 1 diabetes mellitus, presymptomatic,
  Stage 2
• Confirmed islet autoimmunity with dysglycemia

6
Mental, Behavioral and Neurodevelopmental
disorders Chapter 5

• F50.020 Anorexia nervosa, binge eating/purging
  type, mild
• Anorexia nervosa, binge eating/purging type,
  with a body mass index greater than or equal to
  17 kg/m2
• F50.021 Anorexia nervosa, binge eating/purging
  type, moderate
• Anorexia nervosa, binge eating/purging type,
  with a body mass index of 16.0-16.99 kg/m2
• F50.022 Anorexia nervosa, binge eating/purging
  type, severe
• Anorexia nervosa, binge eating/purging type, with
  a body mass index of 15.0-15.99 kg/m2
• F50.023 Anorexia nervosa, binge eating/purging
  type, extreme
• Anorexia nervosa, binge eating/purging type, with
  a body mass index of less than 15.0 kg/m2
• F50.024 Anorexia nervosa, binge eating/purging
  type, in remission
• Anorexia nervosa, binge eating/purging type, in
  full remission
• Anorexia nervosa, binge eating/purging type, in
  partial remission
• F50.029 Anorexia nervosa, binge eating/purging
  type, unspecified

7
Diseases of the nervous system chapter 6

• G40.8 Other epilepsy and recurrent seizures
• G40.84 KCNQ2-related epilepsy
• G40.841 KCNQ2-related epilepsy, not intractable,
  with status epilepticus
• G40.842 KCNQ2-related epilepsy, not intractable,
  without status epilepticus
• KCNQ2-related epilepsy NOS
• G40.843 KCNQ2-related epilepsy, intractable, with
  status epilepticus
• G40.844 KCNQ2-related epilepsy, intractable,
  without status epilepticus

8
Diseases of the circulatory system chapter 9

• I16.1 Hypertensive emergency
• Use Additional code, if applicable, to identify
  specific organ dysfunction, such as
• acute kidney injury (N17.-)
• acute myocardial infarction (I21.-)
• acute pulmonary edema (left and/or right
  ventricular failure) (J81.0, I50.-)
• aortic dissection (I71.0-)
• cerebral hemorrhage (I60.-. I61.-, I62.-)
• cerebral infarction (I63.-)Add eclampsia (O15.-)
  
• hypertensive encephalopathy (I67.4)
• seizure (R56.9)

9
Diseases of the respiratory system chapter 10

• J34.82 Nasal valve collapse
• Nasal valve compromise
• Nasal valve stenosis
• Code first underlying cause, such as
• deviated nasal septum (J34.2)
• J34.820 Internal nasal valve collapse
• J34.8200 Internal nasal valve collapse,
  unspecified
• J34.8201 Internal nasal valve collapse, static
• Narrowing of the septum, head of the inferior
  turbinate and the upper lateral cartilage
• J34.8202 Internal nasal valve collapse, dynamic
• Collapse or falling of the upper, middle sidewall
  of the nose on inspiration
• J34.821 External nasal valve collapse
• J34.8210 External nasal valve collapse,
  unspecified Add
• J34.8211 External nasal valve collapse, static
• Fixed narrowing of the caudal septum, lower
  lateral cartilage, alar rim and nasal sill
• J34.8212 External nasal valve collapse, dynamic
  
• Collapse or falling of the lower sidewall or
  nostril of the nose on inspiration
• J34.829 Nasal valve collapse, unspecified

10
Diseases of the digestive system chapter 11

• K60.3 Anal fistula Add Code first, if applicable
  
• Crohn's disease (K50.-)
• ulcerative colitis (K51.-)
• K60.30 Anal fistula, unspecified
• Anal fistula NOS
• K60.31 Anal fistula, simple
• Low intersphincteric anal fistula
• Superficial anal fistula
• K60.311 Anal fistula, simple, initial
• Anal fistula, simple, new
• K60.312 Anal fistula, simple, persistent
• Anal fistula, simple, chronic
• K60.313 Anal fistula, simple, recurrent
• Anal fistula simple, occurring following complete
  healing
• K60.319 Anal fistula, simple, unspecified

11
Diseases of the skin subcutaneous tissue
chapter 12

• L29.8 Other pruritus
• L29.81 Cholestatic pruritus
• Code also, if applicable, type of liver disease
• Use Additional code for adverse effect, if
  applicable, to identify drug (T36-T50 with fifth
  or sixth character 5)
• L29.89 Other pruritus
• L66.10 Lichen planopilaris, unspecified
• L66.11 Classic lichen planopilaris
• Follicular lichen planus
• L66.12 Frontal fibrosing alopecia
• FFA Add L66.19 Other lichen planopilaris
• Lassueur Graham-Little Piccardi syndrome
• L66.81 Central centrifugal cicatricial alopecia
• L66.89 Other cicatricial alopecia

12
Diseases of musculoskeletal connective tissue
chapter 13

• M51.360 Other intervertebral disc degeneration,
  lumbar region with discogenic back pain only
  Other intervertebral disc degeneration, lumbar
  region with axial back pain only
• M51.361 Other intervertebral disc degeneration,
  lumbar region with lower extremity pain only
  Other intervertebral disc degeneration, lumbar
  region with leg pain only
• Other intervertebral disc degeneration, lumbar
  region with referred sclerotomal pain only
• M51.362 Other intervertebral disc degeneration,
  lumbar region with discogenic back pain and lower
  extremity pain
• Other intervertebral disc degeneration, lumbar
  region with discogenic back pain and leg pain
• Other intervertebral disc degeneration, lumbar
  region with axial back pain and referred
  sclerotomal pain
• M51.369 Other intervertebral disc degeneration,
  lumbar region without mention of lumbar back pain
  or lower extremity pain
• Other intervertebral disc degeneration, lumbar
  region without mention of lumbar back pain or leg
  pain
• Other intervertebral disc degeneration, lumbar
  region, NOS

13
Congenital malformations, deformations and
chromosomal abnormalities chapter 17

• Q23.81 Bicuspid aortic valve Add Congenital
  bicuspid aortic valve
• Add Unicuspid (congenital) aortic valve (at
  birth)
• Add Code also, if applicable, acquired aortic
  valve disorders, such as
• Add aortic (valve) insufficiency (nonrheumatic)
  (I35.1)
• Add aortic (valve) stenosis (nonrheumatic)
  (I35.0)
• Add aortic (valve) stenosis with insufficiency
  (nonrheumatic) (I35.2)
• Add Q23.82 Congenital mitral valve cleft leaflet
• Add Cleft mitral valve leaflet at birth
• Add Q23.88 Other congenital malformations of
  aortic and mitral valves
• Q87.86 Kleefstra syndrome

14
Injury, poisoning and certain other consequences
of external causes chapter 19

• T45.A Poisoning by, adverse effect of and
  underdosing of immune checkpoint inhibitors and
  immunostimulant drugs
• T45.AX Poisoning by, adverse effect of and
  underdosing of immune checkpoint inhibitors and
  immunostimulant drugs
• T45.AX1 Poisoning by immune checkpoint inhibitors
  and immunostimulant drugs, accidental
  (unintentional)
• Poisoning by immune checkpoint inhibitors and
  immunosuppressive drugs NOS
• T45.AX2 Poisoning by immune checkpoint inhibitors
  and immunostimulant drugs, intentional self-harm
• T45.AX3 Poisoning by immune checkpoint inhibitors
  and immunostimulant drugs, assault T45.AX4
  Poisoning by immune checkpoint inhibitors and
  immunostimulant drugs, undetermined
• T45.AX5 Adverse effect of immune checkpoint
  inhibitors and immunostimulant drugs
• T45.AX6 Underdosing of immune checkpoint
  inhibitors and immunostimulant drugs

15
Factors influencing health status and contact
with health services chapter 21

• Z15.1 Genetic susceptibility to epilepsy and
  neurodevelopmental disorders
• Code also, if applicable, related disorders such
  as
• developmental and epileptic encephalopathy
  (G93.45)
• developmental disorder of speech and language
  (F80.-)
• developmental disorders of scholastic skills
  (F81.-)
• epilepsy, by specific type (G40.-)
• intellectual disabilities (F70-F79)
• other neurodevelopmental disorder (F88)
• pervasive developmental disorders (F84.-)

16
Questions???

• Thank you!
• dot_at_dorothysteed.com

Register now