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