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-10CM 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
New
N94.10 Unspecified dyspareunia
New
N94.11 Superficial (introital) dyspareunia
New
N94.12 Deep dyspareunia
New
N94.19 Other specified dyspareunia
R31.2 Other microscopic hematuria
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GREEN CELL:
R82.7 Abnormal findings on microbiological
Removal of text examination
Remove
New
New
a tabular list
Positive culture findings offrom
urine
description
R82.71 Bacteriuria
R82.79 Other abnormal findings
on microbiological
exami
ORANGE
CELL:
R31.21 Asymptomatic microscopic
New
hematuria
AMH
New
BOLD HEADER:
Section of ICD-10-CM under
which the edit occurs
Positive culture findings
of urine
Addition
to a
tabular list
description
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
New
R82.79 Other abnormal findings on microbiological examination of urine
Positive culture findings of urine
Z30.01 Encounter for initial prescription of contraceptives
New
New
New
Z30.015 Encounter for initial prescription of vaginal ring hormonal contraceptive
Z30.016 Encounter for initial prescription of transdermal patch hormonal contraceptive
device
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
New
Z31.7 Encounter for procreative management and counseling for gestational carrier
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
New
Zika virus fever
Zika virus infection
Zika NOS
N61 Inflammatory disorders of breast
N61.0 Mastitis without abscess
New
Infective mastitis (acute) (nonpuerperal) (subacute)
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
New
Abscess (acute) (chronic) (nonpuerperal) of areola
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
New
N83.209 Unspecified ovarian cyst, unspecified side
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
New
N83.319 Acquired atrophy of ovary, unspecified side
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
New
N83.329 Acquired atrophy of fallopian tube, unspecified side
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
New
N83.339 Acquired atrophy of ovary and fallopian tube, unspecified side
Acquired atrophy of ovary and fallopian tube, NOS
N83.4 Prolapse and hernia of ovary and fallopian tube
New
N83.40 Prolapse and hernia of ovary and fallopian tube, unspecified side
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
New
N83.519 Torsion of ovary and ovarian pedicle, unspecified side
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
New
N83.529 Torsion of fallopian tube, unspecified side
Torsion of fallopian tube, NOS
September 2016
NEW CODES (RELATED TO REPRODUCTIVE HEALTH)
N90.6 Hypertrophy of vulva
New
New
New
N90.60 Unspecified hypertrophy of vulva
Unspecified hypertrophy of labia
N90.61 Childhood asymmetric labium majus enlargement
CALME
N90.69 Other specified hypertrophy of vulva
Other specified hypertrophy of labia
N93 Other abnormal uterine and vaginal bleeding
New
N93.1 Pre-pubertal vaginal bleeding
O00.0 Abdominal pregnancy
New
New
O00.00 Abdominal pregnancy without intrauterine pregnancy
Abdominal pregnancy NOS
O00.01 Abdominal pregnancy with intrauterine pregnancy
O00.1 Tubal pregnancy
New
New
O00.10 Tubal pregnancy without intrauterine pregnancy
Tubal pregnancy NOS
O00.11 Tubal pregnancy with intrauterine pregnancy
O00.2 Ovarian pregnancy
New
New
O00.20 Ovarian pregnancy without intrauterine pregnancy
Ovarian pregnancy NOS
O00.21 Ovarian pregnancy with intrauterine pregnancy
O00.8 Other ectopic pregnancy
New
New
O00.80 Other ectopic pregnancy without intrauterine pregnancy
Other ectopic pregnancy NOS
O00.81 Other ectopic pregnancy with intrauterine pregnancy
O00.9 Ectopic pregnancy, unspecified
New
New
O00.90 Unspecified ectopic pregnancy without intrauterine pregnancy
Ectopic pregnancy NOS
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 device
Z01.411 Encounter for gynecological examination (general) (routine) with abnormal
findings
New
Use Additional code to identify abnormal findings
Z01.419 Encounter for gynecological examination (general) (routine) without
abnormal findings
Remove
Use Additional code to identify abnormal findings
Z12.4 Encounter for screening for malignant neoplasm of cervix
Remove
Excludes1: encounter for screening for human papillomavirus (Z11.51)
New
Excludes2: encounter for screening for human papillomavirus (Z11.51)
September 2016
EDITS TO TABULAR LIST DESCRIPTIONS
Z30.018 Encounter for initial prescription of other contraceptives
New
Encounter for initial prescription of barrier contraception
New
Encounter for initial prescription of diaphragm
Z30.49 Encounter for surveillance of other contraceptives
New
Encounter for surveillance of barrier contraception
New
Encounter for surveillance of diaphragm
Z33.1 Pregnant state, incidental
New
Excludes1: pregnant state, gestational carrier (Z33.3)
New
Excludes1: encounter for procreative management and counseling for gestational carrier
(Z31.7)
Z86.00 Personal history of in-situ neoplasm
New
Conditions classifiable to D00-D09
Z86.001 Personal history of in-situ neoplasm of cervix uteri
New
Personal history of cervical intraepithelial neoplasia III [CIN III]
Z86.008 Personal history of in-situ neoplasm of other site
New
Personal history of vaginal intraepithelial neoplasia III [VAIN III]
New
Personal history of vulvar intraepithelial neoplasia III [VIN III]
Z87.41 Personal history of dysplasia of the female genital tract
New
Excludes1: personal history of intraepithelial neoplasia III of female genital tract (Z87.001,
Z87.008)
Z97.5 Presence of (intrauterine) contraceptive device
Remove
Excludes1: checking, reinsertion or removal of contraceptive device (Z30.43)
New
Excludes1: checking, reinsertion or removal of implantable subdermal contraceptive
(Z30.46)
New
Excludes1: checking, reinsertion or removal of intrauterine contraceptive device (Z30.43-)
September 2016