Total number of code changes are ICD-10-CM are 473.  279 new codes, 143 revised codes and 51 deactivated codes.

Just as we’ve gotten all of the latest modifications under our belt, it’s time to start looking at the new code changes for 2019. The good news is that the number of changes this year has continued on a downward trend.  There were far fewer changes to deal with than there were in the larger updates released in the first few years after ICD-10 was implemented.

So let’s dive into the 2019 changes released by the Centers for Medicare and Medicaid Services (CMS) to the ICD-10-CM and ICD-10-PCS code classifications. The changes apply to discharges beginning October 1, 2018 and are effective through September 30, 2019.

ICD-10-CM

For 2019 there are 473 changes to ICD-10-CM: 279 new codes, 143 revised codes, 51 activated codes.

An example of one of the changes comes from ICD-10-CM Chapter 2 Neoplasms. Several codes have been added to this chapter in code range C43-C44. The new codes allow for greater specificity when coding malignant neoplasm of the eyelid by expanding the codes for right and left eyelid to indicate whether it is the upper or lower eyelid that is affected.

ICD-10-PCS

For 2019 there are 616 changes to ICD-10-PCS: 392 new codes, 8 revised codes, 216 deleted codes.

In addition to the changes in codes, ICD-10-PCS has made four changes to the Official Guidelines for Coding and Reporting: changes to the wording of ICD-10-PCS coding convention A10 and guidelines B3.7 and B6.1A as well as the addition of a new guideline.

The new guideline, B3.17 Transfer procedures using multiple tissue layers, has been added to provide guidance on assignment of values for body part and qualifier characters when a transfer flap is composed of more than one tissue layer.

Where Can I Find the Changes?

CMS publishes the updates several months before the changes go into effect to allow users to become familiar with them, train staff, and make necessary adjustments to systems such as EHRs.

All members of the HIM community should take some time to get acquainted with the upcoming changes so they are ready for action when the October 1 implementation date arrives.

The files released by CMS include an updated copy of the Alphabetic Indexes, Code Tables, and Tabular List for ICD-10-CM and the Index and Tables for ICD-10-PCS. Detailed addenda files that identify specific changes for each part of the classification are also available.

Files are available for review by visiting the CMS website at the links below.
https://www.cms.gov/Medicare/Coding/ICD10/2019-ICD-10-CM.html
https://www.cms.gov/Medicare/Coding/ICD10/2019-ICD-10-PCS.html
The ICD-10-CM changes can also be found on the website for the National Center for Health Statistics.
https://www.cdc.gov/nchs/icd/icd10cm.htm