Providers will have a total of 473 code changes beginning Oct. 1, including 279 new codes, 143 revised codes and 51 deactivated codes, according to the final list of changes issued June 11 by the Centers for Disease Control and Prevention.
The majority of the new codes added to the final update are codes describing exploitation of children and adults, such as T76.51xD (Adult forced sexual exploitation, suspected, subsequent encounter) and Z91.42 (Personal history of forced labor or sexual exploitation).
The codes were requested by several hospitals, which are seeing an increase in human trafficking cases and finding they don’t have ICD-10-CM codes adequate to differentiate these victims from other abuse victims. CDC is adding new T codes to report for cases of suspected and confirmed exploitation of children as well as adults. In addition, there are new encounter Z codes added to Chapter 21 for examination and observation of human trafficking victims.
As originally proposed, a go-to code for an infected surgical wound, T81.4xxA, is among the 51 codes that are set to be deleted. In its place, coders will have 15 additional codes added to an expanded T81.4- subcategory that will allow them to more accurately report the depth of the infection.
For example, coders will be able to specify whether the surgical wound infection is affecting the superficial incision surgical site (T81.41-), the deep incisional surgical site (T81.42-) or the organ and space surgical site (T81.43-).
Other surgical site and unspecified options are also available (T81.49- and T81.40-). Each of these codes requires a seventh character: “A,” “D” or “S.”
New codes T81.41-, T81.42- and T81.43- will receive additional inclusion terms to help guide coders to the appropriate code choice. “Subcutaneous abscess following a procedure” and “stitch abscess following a procedure” will be placed at T81.41-.
“Intra-muscular abscess following a procedure” will be added to T81.42- while “intra-abdominal abscess following a procedure” and “subphrenic abscess following a procedure” will be placed at T81.43-.
Additionally, three new codes are proposed to uniquely capture postprocedural sepsis, T81.44- (Sepsis following a procedure), with seventh character options “A,” “D” or “S.” In the current code set, postprocedural sepsis is coded to the same code for an infected surgical wound, T81.4-.
The tabular instruction to “use additional code to identify the sepsis” will be added to the new postprocedural sepsis code T81.44.