QUESTION: Are there updates to ICD-10? I recall that ICD codes update on Oct. 1 of each year, although they are technically 2019 changes.
You are correct – changes for ICD-10 take place Oct. 1, as they have since the inception of ICD-10 (and for that matter, ICD-9). This year is no different, and there are several changes that will likely affect the chiropractic provider.
Some years (2016-2017 is a good example), there were significant changes and additions to cervical disc conditions, TMJ disorders, and neuralgia of the extremities, which accounted for about 75 codes that are common to the doctor of chiropractic. However, the 2017-2018 changes were minor, with only a slight update to lumbar spinal stenosis.
The updates for 2019, however, although not as great in number as 2016-2017, are significant. Here is the summary of updates. There are now 71,932 distinct ICD-10-CM codes for 2019. This represents an addition of 279 codes, 51 deletions and 143 revisions.
New Codes for Myalgia
The significant change for doctors of chiropractic are the codes for myalgia – muscle pain often referred to as myofascial pain syndrome. The most common etiology is likely chronic muscle tension, overuse or injury / trauma. The current code, M79.1, is being deleted and replaced with four new codes that provide greater specificity:
M79.10 Myalgia, unspecified site
M79.11 Myalgia of mastication muscle
M79.12 Myalgia of auxiliary muscles, head and neck
M79.18 Myalgia, other site
Of these four codes, the most likely used in a chiropractic setting may be M79.12, which identifies an involved muscle of the neck and head; or M79.18, which identifies "other site" – a region that can be identified, but is not the muscles of mastication or muscles of the head and neck. M79.10, though a viable code, is not likely to be used, as "unspecified" is referring to a region you cannot define. Clearly, if you identify myalgia, it will be in a region and in that sense, any area other than muscles of mastication or auxiliary muscles of the head and neck would be M79.18 Other site.
The Type 1 Excludes for myalgia will remain fibromyalgia M79.7 and myositis M60.0 to M60.9, which means you do not code myalgia with any of those codes.
Muscular Dystrophy
The other change that may have some impact on DCs involves coding for muscular dystrophy. The current code, G71.0, is being deleted and, as was the case with myalgia, replaced with four codes that provide greater specificity:
G71.00 Muscular dystrophy, unspecified
G71.01 Duchenne or Becker muscular dystrophy
G71.02 Facioscapulohumeral muscular dystrophy
G71. 09 Other specified muscular dystrophies
While not common, these are conditions that are allowed to be cared for / coded under Aetna's chiropractic policy. And at the very least, they would be a complication of comorbidity of other conditions under care.
Other Code Updates That May Be of Relevance
H57.8 Other specified disorders of eye and adnexa is deleted from ICD-10 as of Oct. 1 and replaced with the following:
H57.89 Other specified disorders of eye and adnexa
F53 Puerperal psychosis is also deleted as of Oct. 1, replaced with the following two codes:
F53.0 Postpartum depression
F53.1 Puerperal psychosis
Note that all of the above changes take effect Oct. 1, 2018, and the codes are based on the date of service. If the services were performed prior to Oct. 1, then use the current codes, but all dates of service thereafter must use the newer codes. Medicare will be updating its coding to reflect these changes. Finally, note that myalgia is considered a category II level C code, which indicates moderate-term care plans.
While there may be no “magic bullet” when it comes to health, this should not dissuade patients or practitioners from seeking out ingredients that offer multiple health benefits. When it comes to dietary supplements, there are thousands upon thousands of choices. So, why not choose one that can address pain and assist with mental health? A supplement that can address inflammation, while also preventing certain types of cancer.
This article focuses on nine severe injuries that are generally not diagnosable until the third to fourth week following the date of injury, including how to diagnose these severe injuries. The discovery of any of these injuries early can make a significant difference in the case outcome.
While canes, braces and posts represent extrinsic methods for lessening adductor moment arms, an intrinsic method for lessening the development of medial knee osteoarthritis occurs when the hip abductor musculature and the iliotibial band are strong enough to create a compressive force capable of stabilizing the lateral knee.
