Monday, December 5, 2022

Endometriosis

Endometriosis is the focus of this month’s “In the kNOW”. 
FY2023 ICD-10-CM updates brought a slew of changes related to coding for endometriosis.  Let’s start by identifying what exactly endometriosis is and how it differs from adenomyosis.  Endometriosis is a condition where endometrial-like tissue grows outside the uterus.  It can be found in or on other body organs.  As we will discover shortly, this is pertinent to one of the coding changes that we have for FY2023.  Adenomyosis, however, is different in that it occurs when the endometrial lining of the uterus grows into the uterine muscle.  It is important to note that the conditions (endometriosis and adenomyosis) can co-exist. Until this FY2023 Coding Update, the conditions were found under the same code, N80.0.  With the update, adenomyosis will be coded to N80.03, and endometriosis of the uterus will be coded to N80.00 (unspecified depth), N80.01 (superficial depth), or N80.02 (deep).
As briefly mentioned earlier, since endometriosis can be found in or on other body organs, the new codes allow coding professionals to distinguish between the depth of the endometriosis when documented.  Superficial, deep, or unspecified are the options, and it may be beneficial for clinical documentation improvement specialists (CDIs) to educate providers on this topic. 
Here is a picture showing the differences between endometriosis and adenomyosis:

Source: https://www.facebook.com/groups/endouae/posts/625626348394613/

The most common locations for endometriosis are the ovaries, fallopian tubes, or pelvis.  However, there are many other body parts where endometriosis can be found and that is relevant to another change that we find in the coding for this condition in FY2023.  Endometriosis can now be specifically coded for the following locations:
            Ovary
            Fallopian tube
            Pelvis
                        Pelvic peritoneum
                        Cul-de-sac (anterior or posterior)
                        Pelvic brim
                        Pelvic sidewall
                        Uterosacral ligament
                        Rectovaginal septum (w/o vagina)
Intestine
                        Rectum
                        Sigmoid
                        Cecum
                        Appendix
                        Other
                        Small
            Bladder
            Ureter
 Cardiothoracic space
                        Pleura
                        Lung
                        Diaphragm
                        Pericardial space
                        Mediastinal space
                        Cardiothoracic space
            Abdomen
                        Anterior abdominal wall
                        Umbilicus
                        Inguinal canal
                        Extra-pelvic abdominal peritoneum
                        Other abdominal site
 Nerves
                        Pelvic nerves
                        Sacral splanchnic nerves
                        Sacral nerve roots
                        Obturator nerves
                        Sciatic nerve
                        Pudendal nerve
                        Femoral nerve
                        Other pelvic nerve
            Other site
           
By adding in the ability to differentiate laterality for many of the above locations as well, it is not hard to see why there are now well over 100 new codes related to endometriosis.           
Now you are In the kNOW!!

 

 

 

About the Author 

Dianna Foley, RHIA, CCS, CHPS, CDIP is OHIMA's Education Coordinator. Dianna has been an HIM professional for over 20 years. She progressed through the ranks of coder, department supervisor, and department director, to her current role as a coding consultant. 

She previously served as the program director for Medical Coding and HIT at Eastern Gateway Community College. Dianna earned her bachelor's degree from the University of Cincinnati and holds RHIA, CHPS, CDIP and CCS certifications. She is an AHIMA Approved ICD-10-CM/PCS Trainer and is a presenter on coding topics at the national, state, and regional levels. Dianna mentors new AHIMA members and also provides monthly educational lectures to coders and clinical documentation specialists.