Changes in Family Planning Coding: Updates to ICD-10-CM Take Effect October 1, 2016 Family planning providers will soon have access to new diagnosis codes, including those that better reflect the full range of contraceptive methods currently available on the market. The Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS) reviewed the International Classification of Diseases, 10th Edition (ICD-10) for use in the US and published changes that will take effect on October 1, 2016. This set of updates are collectively known as the 2017 Addenda and are to be used for patient encounters occurring from October 1, 2016 through September 30, 2017. The 2017 Addenda includes two types of updates: 1) new codes added to ICD-10-CM and 2) edits to descriptive language of current ICD-10-CM codes that will clarify use of codes. Both updates are important for providers to understand. A new code may better represent health care services that are currently provided and should therefore be incorporated into use. A new description for a code currently in use may provide better insight into the appropriate use of codes, or may correct an error in a description that created confusion. The following pages include a list of changes to ICD-10-CM that are pertinent to family planning providers. The document is divided into three sections: 1) new ICD-10-CM codes that may be needed frequently in family planning settings; 2) new ICD-10-CM codes related to reproductive health but used infrequently in family planning settings; and 3) edits to ICD-10- CM tabular list descriptions among codes of interest to family planning providers. This list is not intended to represent all of the changes ICD-10-CM will undergo on October 1, 2016. Providers should review the 2017 Addenda in its entirety and consult payers to confirm their implementation of ICD-10-CM updates. Disclaimer: This reference is for education purposes only. Nothing herein is a specific recommendation about selecting ICD codes. Code selection and claim submission is based upon medical record documentation for services rendered and diagnoses considered for each individual encounter. Providers must check with the coding and coverage guidelines for a particular payer. September 2016 NEW CODES (FREQUENT USE IN FAMILY PLANNING SETTINGS) N94.1 Dyspareunia HOW TO BOLD HEADER: Section of ICD-10-CM under New N94.10 Unspecified dyspareunia READ THIS which the edit occurs New N94.11 Superficial (introital) dyspareunia DOCUMENT New N94.12 Deep dyspareunia GREEN CELL: R82.7 Abnormal findings on microbiologicalRemoval of text examination of urine New N94.19 Other specified dyspareunia Remove Positive culture findings offrom urine a tabular list description New R82.71 Bacteriuria R31.2 Other microscopic hematuria New R82.79 Other abnormal findingsORANGE on microbiological CELL: examination of urine R31.21 Asymptomatic microscopic Positive culture findingsAddition of urine to a tabular list New hematuria description AMH New R31.29 Other microscopic hematuria BLUE CELL: New ICD-10-CM code R82.7 Abnormal findings on microbiological examination of urine Remove Positive culture findings of urine New R82.71 Bacteriuria R82.79 Other abnormal findings on microbiological examination of urine New Positive culture findings of urine Z30.01 Encounter for initial prescription of contraceptives New Z30.015 Encounter for initial prescription of vaginal ring hormonal contraceptive Z30.016 Encounter for initial prescription of transdermal patch hormonal contraceptive New device New Z30.017 Encounter for initial prescription of implantable subdermal contraceptive Z30.4 Encounter for surveillance of contraceptives New Z30.44 Encounter for surveillance of vaginal ring hormonal contraceptive device New Z30.45 Encounter for surveillance of transdermal patch hormonal contraceptive device Z30.46 Encounter for surveillance of implantable subdermal contraceptive New Encounter for checking, reinsertion or removal of implantable subdermal contraceptive Z31 Encounter for procreative management Z31.7 Encounter for procreative management and counseling for gestational carrier New Excludes1: pregnant state, gestational carrier (Z33.3) Z33 Pregnant state New Z33.3 Pregnant state, gestational carrier September 2016 NEW CODES (RELATED TO REPRODUCTIVE HEALTH) A92 Other mosquito-borne viral fevers A92.5 Zika virus disease Zika virus fever New Zika virus infection Zika NOS N61 Inflammatory disorders of breast N61.0 Mastitis without abscess Infective mastitis (acute) (nonpuerperal) (subacute) New Mastitis (acute) (nonpuerperal) (subacute) NOS Cellulitis (acute) (nonpuerperal) (subacute) of breast NOS Cellulitis (acute) (nonpuerperal) (subacute) of nipple NOS N61.1 Abscess of the breast and nipple Abscess (acute) (chronic) (nonpuerperal) of areola New Abscess (acute) (chronic) (nonpuerperal) of breast Carbuncle of breast Mastitis with abscess N83.0 Follicular cyst of ovary New N83.00 Follicular cyst of ovary, unspecified side New N83.01 Follicular cyst of right ovary New N83.02 Follicular cyst of left ovary N83.1 Corpus luteum cyst New N83.10 Corpus luteum cyst of ovary, unspecified side New N83.11 Corpus luteum cyst of right ovary New N83.12 Corpus luteum cyst of left ovary N83.20 Unspecified ovarian cysts New N83.201 Unspecified ovarian cyst, right side New N83.202 Unspecified ovarian cyst, left side N83.209 Unspecified ovarian cyst, unspecified side New Ovarian cyst, NOS N83.29 Other ovarian cysts New N83.291 Other ovarian cyst, right side New N83.292 Other ovarian cyst, left side New N83.299 Other ovarian cyst, unspecified side September 2016 NEW CODES (RELATED TO REPRODUCTIVE HEALTH) N83.31 Acquired atrophy of ovary New N83.311 Acquired atrophy of right ovary New N83.312 Acquired atrophy of left ovary N83.319 Acquired atrophy of ovary, unspecified side New Acquired atrophy of ovary, NOS N83.32 Acquired atrophy of fallopian tube New N83.321 Acquired atrophy of right fallopian tube New N83.322 Acquired atrophy of left fallopian tube N83.329 Acquired atrophy of fallopian tube, unspecified side New Acquired atrophy of fallopian tube, NOS N83.33 Acquired atrophy of ovary and fallopian tube New N83.331 Acquired atrophy of right ovary and fallopian tube New N83.332 Acquired atrophy of left ovary and fallopian tube N83.339 Acquired atrophy of ovary and fallopian tube, unspecified side New Acquired atrophy of ovary and fallopian tube, NOS N83.4 Prolapse and hernia of ovary and fallopian tube N83.40 Prolapse and hernia of ovary and fallopian tube, unspecified side New Prolapse and hernia of ovary and fallopian tube, NOS New N83.41 Prolapse and hernia of right ovary and fallopian tube New N83.42 Prolapse and hernia of left ovary and fallopian tube N83.51 Torsion of ovary and ovarian pedicle New N83.511 Torsion of right ovary and ovarian pedicle New N83.512 Torsion of left ovary and ovarian pedicle N83.519 Torsion of ovary and ovarian pedicle, unspecified side New Torsion of ovary and ovarian pedicle, NOS N83.52 Torsion of fallopian tube New N83.521 Torsion of right fallopian tube New N83.522 Torsion of left fallopian tube N83.529 Torsion of fallopian tube, unspecified side New Torsion of fallopian tube, NOS September 2016 NEW CODES (RELATED TO REPRODUCTIVE HEALTH) N90.6 Hypertrophy of vulva N90.60 Unspecified hypertrophy of vulva New Unspecified hypertrophy of labia N90.61 Childhood asymmetric labium majus enlargement New CALME N90.69 Other specified hypertrophy of vulva New Other specified hypertrophy of labia N93 Other abnormal uterine and vaginal bleeding New N93.1 Pre-pubertal vaginal bleeding O00.0 Abdominal pregnancy O00.00 Abdominal pregnancy without intrauterine pregnancy New Abdominal pregnancy NOS New O00.01 Abdominal pregnancy with intrauterine pregnancy O00.1 Tubal pregnancy O00.10 Tubal pregnancy without intrauterine pregnancy New Tubal pregnancy NOS New O00.11 Tubal pregnancy with intrauterine pregnancy O00.2 Ovarian pregnancy O00.20 Ovarian pregnancy without intrauterine pregnancy New Ovarian pregnancy NOS New O00.21 Ovarian pregnancy with intrauterine pregnancy O00.8 Other ectopic pregnancy O00.80 Other ectopic pregnancy without intrauterine pregnancy New Other ectopic pregnancy NOS New O00.81 Other ectopic pregnancy with intrauterine pregnancy O00.9 Ectopic pregnancy, unspecified O00.90 Unspecified ectopic pregnancy without intrauterine pregnancy New Ectopic pregnancy NOS New O00.91 Unspecified ectopic pregnancy with intrauterine pregnancy September 2016 NEW CODES (RELATED TO REPRODUCTIVE HEALTH) R39.19 Other difficulties with micturition New R39.191 Need to immediately re-void New R39.192 Position dependent micturition New R39.198 Other difficulties with micturition R39.8 Other symptoms and signs involving the genitourinary system New R39.82 Chronic bladder pain September 2016 EDITS TO TABULAR LIST DESCRIPTIONS B17.9 Acute viral hepatitis, unspecified New Acute infectious hepatitis NOS B18 Chronic viral hepatitis New Includes: Carrier of viral hepatitis B18.1 Chronic viral hepatitis B without delta-agent New Carrier of viral hepatitis B B18.2 Chronic viral hepatitis C New Carrier of viral hepatitis C B18.8 Other chronic viral hepatitis New Carrier of other viral hepatitis B18.9 Chronic viral hepatitis, unspecified New Carrier of unspecified viral hepatitis N94.3 Premenstrual tension syndrome New Excludes1: Premenstrual dysphoric disorder (F32.81) T83.32 Displacement of intrauterine contraceptive device New Missing string of intrauterine contraceptive