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Medical Coding News Archives

December Coding Corner

December 7, 2016:

In the Optum360 Coding Corner, we highlight areas in which medical coding professionals are struggling for uniformity and correct coding amongst their peers. In this article, we will discuss coding variances for ICD-10-CM, ICD-10-PCS and/or CPT® found on a monthly basis and explore the codes, coding concepts and conventions for those variances. We will also highlight new coding information when applicable, to keep the coding community informed.

ICD-10-CM (both Inpatient and Outpatient settings)

Gastrointestinal Stroma Tumor (GIST)

With the ICD-10 update, seven new diagnosis codes have been created to identify Gastrointestinal Stroma Tumor (GIST). Six of the new diagnosis codes identify the site of the tumor. If the documentation does not specify the site of the tumor, diagnosis codes C49.A0 (Gastrointestinal stromal tumor, unspecified site) should be coded. The other codes created to identify a GIST are: C49.A1 (Gastrointestinal stromal tumor of esophagus), C49.A2 (Gastrointestinal stromal tumor of stomach), C49.A3 (Gastrointestinal stromal tumor of small intestine), C49.A4 (Gastrointestinal stromal tumor of large intestine), C49.A5 (Gastrointestinal stromal tumor of rectum) and C49.A9 (Gastrointestinal stromal tumor of other sites).


Two new diagnosis codes have been created during the I10 update for this section. The new diagnosis codes are E78.00 (Pure hypercholesterolemia, unspecified) and E78.01 (Familial hypercholesterolemia). According to the AHA Coding Clinic the new diagnosis codes were created “to improve detection and screening in patient with this treatable condition.”


Knee Replacement

A new device value of L (Synthetic Substitute, Unicondylar) has been created to identify when a synthetic device is used for a knee replacement. PCS table 0SR (Replacement of Lower Joints) will be impacted by this change.

Zooplasatic Tissue Substitute

A new device value of 8 (Zooplastic Tissue) has been created to identify when bioprosthetic devices are in a bypass procedure of the heart or great vessels. PCS table 021 (Bypass of Heart and Great Vessels) will be impacted by this change.

Bone Marrow and Stem Cell Transfusion

The Qualifier value that describes transfusion of stem cells has been expanded to four values. The term Nonautologous has been changed to Allogeneic and identifies the relationship of the donor to the patient. The Value of 1 (Nonautologous) has been deleted and values of 2 (Allogeneic, Related), 3 (Allogeneic, Unrelated) and 4 (Allogeneic, Unspecified) have been created. According to Coding Clinic, “the changes restore detail that was available in ICD-9-CM.”

CPT is a registered trademark of the American Medical Association.


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