ICD-10 Code Changes for 2021
Effective October 1, 2020
Code changes are effective 10-1-2020 and based on date of service, not billing date.
New codes must be used for services occurring on or after October 1.
New Codes for Headache
The updated code(s) most affecting chiropractic providers for the upcoming year is R51 Headache, which has been deleted and replaced.
Code R51 was the diagnosis code used for headache, with the following approximate synonyms:
Cervicogenic headache
Chronic facial pain
Chronic mixed headache syndrome
Chronic pain in face
Craniofacial pain
Daily headache
Facial pain
Facial pain, chronic
Headache, cervicogenic
Headache, chronic daily
Headache, mixed
Headache, occipital
Headache, sinus
Occipital headache
Pain in face
Sinus headache
Sinus pain
There will be two new codes to replace R51:
R51.0 Headache with orthostatic component, not elsewhere classified
R51.9 Headache, unspecified
**To avoid denial, claims need to be coded to the highest level of specificity.
Orthostatic headache is a condition in which a person develops a headache while vertical, and the headache is relieved when horizontal. Previously, it was often misdiagnosed as different primary headache disorders such as migraine or tension headaches. - Wikipedia
Based on this clarification, the common headache code replacing R51 would be R51.9 headache, unspecified, which would include all the synonyms noted above.
These codes have been modified in the Document Plus software for use on the Clinical Exam and Daily Note Forms.
New Codes for TMJ Issues
Used less frequently, but well within the scope of neuromusculoskeletal coding for chiropractors, there are some additions for temporomandibular joint (TMJ) issues. Chiropractors do treat TMJ conditions, which include codes for TMJ disorders M26.601 through M26.603; and sprain and strain of the jaw M26.621 through M26.629 and M26.31 to M26.639. The new additions specifically address arthritis and arthropathy for TMJ:
M26.641 Arthritis of right temporomandibular joint
M26.642 Arthritis of left temporomandibular joint
M26.643 Arthritis of bilateral temporomandibular joint
M26.649 Arthritis of unspecified temporomandibular joint
M26.651 Arthropathy of right temporomandibular joint
M26.652 Arthropathy of left temporomandibular joint
M26.653 Arthropathy of bilateral temporomandibular joint
M26.659 Arthropathy of unspecified temporomandibular joint
These codes have been modified in the Document Plus software for use on the Clinical Exam and Daily Note Forms.
Code Changes for Other Joint-Related Disorders
Other new codes involve joint-related disorders for “other specified joints”. These include:
M19.09 Primary osteoarthritis, other specified site
M19.19 Post-traumatic osteoarthritis, other specified site
M19.29 Secondary osteoarthritis, other specified site
M24.19 Other articular cartilage disorders, other specified site
M24.29 Disorder of ligament, other specified site
M24.39 Pathological dislocation of other specified joint, not elsewhere classified
M24.49 Recurrent dislocation, other specified joint
M24.59 Contracture, other specified joint
M24.69 Ankylosis, other specified joint
M24.89 Other specific joint derangement of other specified joint, not elsewhere classified
M25.39 Other instability, other specified joint
M25.59 Pain in other specified joint
M25.69 Stiffness of other specified joint, not elsewhere classified
All codes have been modified in the Document Plus software via automatic update for use on the Clinical Exam and Daily Note Forms for users with a current support contract.
**IMPORTANT**
***If your annual support contract is CURRENT, you should see the code additions in their appropriate locations. If you navigate to one of the appropriate locations in the software and DO NOT see the new codes, please close Document Plus, re-open the software and check again.
***If your annual support contract has EXPIRED, please contact a Document Plus representative and renew to ensure that you continue to receive the latest software updates.
Training: 888-588-6648 – Melanie
Support: 800-642-0600 Ext. 201 - Bryan or Mike
Body Location Diagnosis Entry (BLDE) screen
The Body Location Diagnosis Entry (BLDE) screen is one way for you to add Diagnosis codes to your reports. The BLDE is accessible in three locations; (1) Daily Notes 3 & 4, "New Additional Bubble, (2) CE3b Page 7, "Body Dx Selection" bubble, (3) CE2 & RE2, Page 4, second lumbosacral "Other" bubble
The Body Location Diagnosis Entry (BLDE) screen can ONLY be customized from the “New Additional” bubble under Assessment, Diagnosis on the Daily Note 3 (DN3) form.
The Body Locations Diagnosis Entry (BLDE) screen ONLY needs to be modified ONCE from that location. Updates will then appear in ALL available locations.
Again, the code changes have been added to your Document Plus software via automatic update and there is nothing more that you need to do.
In the case that you would like to add, remove, or reorganize codes in the BLDE screens, we have included the following STEP-BY-STEP TUTORIAL for your convenience.
If you need assistance, please contact Melanie at 888-588-6648