Updated 2021 ICD-10-CM Coding Guidelines Now Available

Updated 2021 ICD-10-CM Coding Guidelines Now Available

CMS has released updates to the ICD-10-CM and ICD-10-PCS codes for January 1, 2021. This includes 27 new codes: 21 PCS and six CM codes. In addition, for the diagnosis codes, CMS released the changes to the ICD-10-CM Official Guidelines on December 16, 2020; these changes reflect these six new codes.

These updates include substitution of the new code for pneumonia due to COVID-19, J12.82; contact with and (suspected) exposure to COVID-19, Z20.822; and personal history of COVID-19, Z86.16. There is also a new section in the guidelines pertaining to multisystem inflammatory syndrome, M35.81. Code M35.89 for other specified systemic involvement of connective tissue is also available but not included in the guidelines.

Although CMS released a new code for COVID-19 screening, Z11.52, the guidelines specify that this code is not appropriate during the pandemic, and that coders should not report it. Instead, coders should code encounters for COVID-19 testing, including preoperative testing, as exposure to COVID-19. Furthermore, the guidelines state that this advice will be updated as the status of the pandemic changes and the reporting of the screening code is applicable.

Additional Information

You can download the addenda for the tabular list and index related to these code changes for January 2021 from the CDC website (2020).

For more information, see the CDC announcement of the ICD-10-CM codes effective on January 1, 2021 (CDC, 2020).

In this unprecedented year for coding updates, it’s important to secure the highest quality medical coding education for your team. Contact YES HIM Consulting today to discuss our practical education and tailored coding support solutions. For more information on our 2021 ICD-10 Updates courses, visit our YES HIM Education page. Read our article, “27 New ICD-10 Codes for COVID-19-Related Conditions, Monoclonal Antibodies, & More Take Effect January 1, 2021,” for a review of the 27 new ICD-10 codes that go into effect on January 1, 2021.

Ann Zeisset, RHIT, CCS, CCS-P, co-authored this article with Teri Jorwic, MPH, RHIA, CCS, CCS-P, FAHIMA.

Teri Jorwic

Contract Educator, MPH, RHIA, CCS, CCS-P, FAHIMA
2021 ICD-10-CM coding guidelines

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