With the new 2019 ICD-10-CM code set now available, we know that there have been more than 740 different changes. More than 30 of the changes for 2019 actually apply to Obstetrics and Gynecology (OB-Gyn) correction, from changes and updates to coding multiple gestation pregnancies to coding for obstetric surgical wound infections. Here’s a closer look at some of the relevant changes to the ICD-10 codes for your OB-GYN practice.
Inter-professional Telephone/Internet/Electronic Health Record Consultations
- 99451 – Inter-professional telephone/Internet/electronic health record assessment and management service provided by a consultative physician including a written report to the patient’s treating/requesting physician or other qualified health care professional; 5 minutes or more of medical consultative time
- 99452 – Inter-professional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional, 30 minutes.
Digitally Stored Data Services/Remote Physiologic Monitoring
- 99453 – Remote monitoring of physiologic parameter(s) (eg. weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on the use of equipment
- 99454 – device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days
Evaluation and Management
Remote Physiologic Monitoring Treatment Management Services
- 99457 – Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month
Chronic Care Management Services
- 99491 – Chronic care management services provided personally by a physician or other qualified health care professional, at least 30 minutes of physician or other qualified health care professional time, per calendar month, with the following required elements:
- Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient;
- Chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline;
- Comprehensive care plan established, implemented, revised, or monitored.
A new code subsection has been added for Fine Needle Aspiration Biopsy (FNA). Multiple new codes have been added to the new subsection to describe FNA codes with and without guidance (eg. ultrasound, fluoroscopic, CT, and MR guidance) and to describe the initial lesion and additional lesions.
Fine Needle Aspiration Biopsy (FNA)
New Code(s): 10004 – 10012. Code 10021 – Fine needle aspiration; without imaging guidance has been revised. The new code description reads as Fine needle aspiration; without imaging guidance, the first lesion.
Skin, Subcutaneous, and Accessory Structures
- New Code(s): 11102 – 11107. Several new codes have been introduced to identify reporting for different types of biopsy (eg. tangential, punch, incisional)
- Codes 11100 – Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; single lesion and 11101 – Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; each separate/additional lesion (List separately in addition to code for primary procedure) have been deleted.
Lymph Nodes and Lymphatic Channels
- 38531 – Biopsy or excision of lymph node(s) open, inguinofemoral node(s) has been introduced to add excision of inguinofemoral nodes to the lymph nodes and lymphatic channels code family. Code 38531 has been added to the parenthetical for add-on code 38900 – Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye when performed (List separately in addition to code for primary procedure). Both codes may be reported together when performed.
A parenthetical has been added to the codes for partial and complete radical vulvectomy (56630- 56632 and 56633-56637) instructing the user to report code 38531when an inguinofemoral lymph node biopsy is performed without a complete inguinofemoral lymphadenectomy.
OB/GYN coding is already difficult, and these new changes to the ICD-10 codes for 2019 only add to coding difficulties for your practice. Simply forgetting to add additional characters to codes that specify a type of surgical wound is enough to get your claim denied, and denials can cost your practice big time. Through outsourcing, many OB-GYN practices are able to improve billing and coding efficiency so they’re able to spend more time focusing on offering patients quality patient care. Medical Billers and Coders (MBC) is a reputable medical billing and coding company that offers the highest quality service for clients across the country. To learn more about how we can end your OB/GYN billing and coding difficulties, contact us today.