Fall 2020 SNOMED-CT and ICD-10 Updates Add COVID-19-Related Issues and Other Diagnoses
On September 20th of 2020, PCC updated the SNOMED-CT diagnostic terms and the ICD-10 diagnosis billing codes on your practice’s system.
PCC regularly updates your system’s ICD-10, LOINC, SNOMED-CT, NDC, RVU, VIS, and other standardized lists so you won’t encounter challenges when you chart, order a lab, interface with a care provider, or bill for a visit. (Your practice’s local system automatically updates your practice’s procedure code validation, as well.)
In PCC EHR, clinicians enter diagnoses using SNOMED, which maps to ICD-10 billing codes for claims. We updated both of these codesets in order to provide you with the most up-to-date diagnostic language in the chart, and to support the 2021 edition of ICD-10, which takes effect for dates of service after 2020-10-01.
Read the sections below to learn about the updates, educational opportunities, and diagnosis codes and descriptions of particular interest to pediatricians.
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Use 2021 ICD-10 Diagnosis Billing Codes, Including New COVID-Related Codes
The 2021 ICD-10 update includes new sections for COVID-19-related infections and vaping-related disorders. You can review the complete, updated guidelines in the CDC’s ICD-10-CM Official Guidelines for Coding and Reporting.
The new codes and guidelines take effect for dates of service starting on 10/1/2020. You can learn about the updates that are of most interest to pediatric practices by attending PCC Web labs held by Jan Blanchard (CPC, CPEDC). Missed a web lab? You can watch a recorded session as well.
In addition to COVID-19 and vaping-related guidelines and codes, Jan notes that the 2021 ICD-10 update includes more specificity for substance abuse codes, several adjustments to influenza coding, and new codes for reflux, headaches/face pain, and more. In the “curiosities” bucket, the update includes “Pedestrian on electric scooter and standing micro-mobility pedestrian conveyance (hoverboard, segway)” added to V00-V06.
Chart Diagnoses Mapped to Deprecated ICD-10 Billing Codes: Were there any 2021 code changes for items that your practice frequently bills? You can review your system configuration using the snomedmap report tool in Partner. While there were no major disruptions in the 2021 ICD-10 update, it’s always worth taking a look at your code mapping reports to head off any billing challenges.
Use the Latest SNOMED Diagnoses, Including New COVID-Related Descriptions
The SNOMED-CT update includes thousands of new descriptions for diagnoses, allergies, therapies, and procedures. It also updates thousands of text descriptions for diagnoses and their mapped ICD-10 billing codes. You can review information about the update on the National Library of Medicine website.
Review Your COVID-19 SNOMED to ICD-10 Mapping: As codesets continue to change in response to COVID-19, PCC recommends you review the diagnoses you use to chart and bill for COVID-19 issues. For example, this update includes a new recommended mapping of the Exposure to SARS-CoV-2 SNOMED description to the Z20.828 ICD-10 code. This mapping was not included by default in the previous SNOMED standard. You can double-check your practice’s diagnosis billing configuration in the Billing Configuration tool.
New COVID-19-Related Diagnosis Descriptions
The update includes 22 new diagnoses for the use of identifying when an issue is related to COVID-19. For example, there are new descriptions for otitis media and several new descriptions for respiratory distress and infections, pneumonia, bronchitis, and similar. For a complete guide to COVID-19-related descriptions, you can read the COVID-19 section of the SNOMED-CT International Release Notes.
| Acute bronchitis caused by SARS-CoV-2 |
| Asymptomatic SARS-CoV-2 |
| Acute hypoxemic respiratory failure due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
| Acute kidney injury due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
| Acute respiratory distress syndrome due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
| At increased risk of exposure to Severe acute respiratory syndrome coronavirus 2 |
| Cardiomyopathy due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
| Conjunctivitis due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
| Dyspnea caused by Severe acute respiratory syndrome coronavirus 2 |
| Encephalopathy due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
| Fever caused by Severe acute respiratory syndrome coronavirus 2 |
| Infection of upper respiratory tract caused by Severe acute respiratory syndrome coronavirus 2 |
| Lower respiratory infection caused by SARS-CoV-2 |
| Lymphocytopenia due to Severe acute respiratory syndrome coronavirus 2 |
| Myocarditis due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
| Pneumonia caused by SARS-CoV-2 |
| Otitis media due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
| Rhabdomyolysis due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
| Sepsis due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
| Severe acute respiratory syndrome coronavirus 2 detected |
| Severe acute respiratory syndrome coronavirus 2 not detected |
| Thrombocytopenia due to Severe acute respiratory syndrome coronavirus 2 |
New Favorites Available in Diagnosis Quick Search
The update adds 2043 diagnosis descriptions to your system. PCC added 245 of them to the “Favorites” quick search feature of all diagnosis fields in PCC EHR.
In preparation for the update, PCC’s certified coder, Jan Blanchard, assembled a list of 245 new SNOMED-CT descriptions of interest to pediatricians. The update added these diagnoses to your practice’s default Favorites list for quick searching, unless your practice has specifically requested otherwise.
What is a diagnosis 'Favorites' list?: As you type or search in any diagnosis field, PCC EHR automatically searches a customizable list of Favorites. Use the Diagnosis Configuration tool to adjust your practice’s list of Favorites. You can also right-click on any diagnosis field in PCC EHR to search your system’s full SNOMED-CT diagnosis library.
You can review the list of 245 new Favorite descriptions. Attend PCC’s monthly coding weblabs to learn more about the new descriptions and other coding topics.
Deprecated SNOMED Diagnosis Descriptions
The Fall 2020 SNOMED-CT update removes or replaces many codes common to pediatric practices. Your practice may want to take special note of them.
Here are the top 25 codes from PCC’s pediatric practices that have been removed from the SNOMED-CT diagnosis library in 2020. When these codes appeared for selection on a chart note protocol, PCC added a replacement if available. For other diagnoses, your providers can usually find new appropriate descriptions with a search, but you may want to plan ahead.
| Allergy to edible egg | 91930004 |
| Seborrhea | 86708008 |
| Sprain, ankle joint, lateral | 209532000 |
| Allergic reaction to insect bite | 213024000 |
| Dermoid cyst of skin | 276729007 |
| Hearing loss in right ear | 1091501000119106 |
| Pilonidal cyst with abscess | 85224001 |
| Allergic reaction, due to correct medicinal substance properly administered | 57302007 |
| Toxic erythema | 58767000 |
| Infective hepatitis immunization | 275849001 |
| Sprained finger/thumb | 287097007 |
| Adverse effect, due to correct medicinal substance properly administered | 45376003 |
| Pilonidal cyst without abscess | 76545008 |
| Adverse reaction to vaccine properly administered | 699017007 |
| Allergic reaction to bite and/or sting | 418484009 |
| Gastrointestinal allergy to food | 414314005 |
| Photosensitization due to sun | 258155009 |
| Sprain of toe joint | 262998001 |
| Angioedema of eyelids | 402405007 |
| Angioedema of lips | 402406008 |
| Adverse drug reaction resulting from treatment of disorder | 708809007 |
| Discharge of eye | 18628002 |
| Allergic reaction to systemically administered drug affecting oral mucosa | 702559001 |
| Facial seborrheic dermatitis | 402210009 |
SNOMED Codes Mapped to ICD-10 for Billing
The SNOMED-CT update includes new mappings to ICD-10 billing codes. Many previous mappings have been updated.
You may wish to review billing configuration for your diagnoses. You can open the Billing Configuration tool to configure which ICD-10 diagnoses are mapped to each SNOMED-CT description in PCC EHR. You can also use the snomedmap report tool to examine your practice’s diagnoses that may need updating.