News: Cooperating Parties approve FY 2020 ICD-10-CM guidelines

The four Cooperating Parties (the American Health Information Management Association, the American Hospital Association, CMS, and the National Center for Health Statistics) recently approved the fiscal year (FY) 2020 ICD-10-CM Official Guidelines for Coding and Reporting, which include updated guidance for reporting pressure-induced deep tissue damage, multiple drugs or medicinal substances, injuries and complications, according to JustCoding.

• Pressure ulcers: Previously, the Guidelines instructed coding professionals to report pressure ulcers that are documented as “deep tissue injury” but not those documented as “due to trauma,” as “unstageable.” New guideline 1.C.12.a.7 states that pressure-induced deep tissue damage or deep tissue pressure injury should be reported using the appropriate ICD-10-CM code from category L89.- (pressure ulcer) for pressure-induced deep tissue damage. 
• Poisonings, adverse effects, and underdosing: Per the updated Guidelines, when multiple unspecified drugs, medicinal or biological substances are documented as the cause of a poisoning, adverse effect, or underdosing, the coder would assign the appropriate ICD-10-CM code from subcategory T50.91- (poisoning by, adverse effect of, and underdosing of multiple unspecified drugs, medicaments, and biological substances).
• Complications: The Guidelines offer new clarification for reporting complication codes from the body system chapters. According to the Guidelines, complication codes from Chapters 1-17 should be assigned for intraoperative and postprocedural complications unless the complication is specifically indexed to an external cause code in Chapter 19, “Injuries, Poisonings, and Certain Other Consequences of External Causes.”
• Injuries: Iatrogenic injury codes from Chapter 19 should not be assigned for injuries that occur during, or as a result of, a medical intervention, according to the updated Guidelines. Coders should instead report the appropriate complication code. The Guidelines also offer new rules for reporting physeal fractures, or disruptions in the cartilaginous physis of the long bones that may involve the epiphyseal or metaphyseal bone. Coders are instructed to assign only one ICD-10-CM code to identify the type of physeal fracture. They should not assign a separate code to identify the specific bone that was fractured.

The new Guidelines will be in effect for discharges from October 1, 2019, through September 30, 2020, coinciding with the implementation of the FY 2020 inpatient prospective payment system (IPPS) final rule.

Editor’s note: This article originally appeared in JustCoding. To read the full FY 2020 Official Guidelines, click here. To learn more about the IPPS final rule, click here.