The Coding Corner


NEPHO is happy to announce the newest section on our website focused on coding. This information will be updated with the most up to date information related to medical coding. This information will help support efforts to capture codes that Risk Adjust, provide providers with CMS updates that impact revenue reimbursement, and offer guidance to stay in compliance with billing and coding requirements.

Featured this month are the 2019 ICD-10 CM and CPT Updates. Please feel free to contact Shawn Bromley with questions related to coding at or


ICD-10 CM 2019 Updates: Effective October 1, 2018

ICD-10 CM 2019 Updates: Effective October 1, 2018
The Center for Disease Control recently released the 2019 ICD 10 CM codes that will go into effect on October 1, 2018 and will be in effect until September 31, 2019. The changes include the addition of 279 new codes, 51 deleted codes and 143 codes that have been revised.  After these changes go into effect on October 1, 2018 there will be 71,932 active ICD 10 CM codes.

The following chapters have the greatest changes:

  • Chapter 2: Neoplasms – all 45 new codes in this chapter are related to the upper/lower eyelids right or left eye
  • Chapter 7: Diseases of the Eye and Adnexa that also now specify upper or lower lids
  • Chapter 11: Diseases of the Digestive System will have 15 new codes some demonstrating a breakout of generalized versus localized peritonitis in association with acute appendicitis. This chapter will see five deleted codes and one revised code.
  • Chapter 14: Diseases of the Genitourinary System will have 17 new codes related to urethral strictures to further specify anatomy, underlying cause and patient gender. There will be two deleted codes and one revised.
  • Chapter 15: Pregnancy, Childbirth and the Puerperium will have 18 new codes covering triplets, quadruplets and other specified multiple gestations.
  • Chapter 16: Certain Conditions Originating in the Perinatal Period will see 25 new codes dealing with newborn complications related to maternal drug use, metabolic disorders in the newborn and newborns affected by the Zika Virus. Five codes are being deleted replaced with the more specific new codes.

Chapter 19: Injury, Poisoning, and Certain other Consequences of External Causes will have 54 new codes, 3 deleted and 87 revised codes.

As noted above there are a total of 143 revised codes that you may be hard pressed to identify the change, this is because most were spacing or spelling corrections. (CMS website link)

CPT 2019 Code Updates: Effective January 1, 2019

There will be 335 CPT code changes in the CPT for 2019:

  • 212 codes are being added
  • 73 are being deleted
  • 50 are being revised
  • The AMA evaluates and changes the code annually to reflect scientific and technological advances in medical, surgical and diagnostic services
  • In addition to the changes that help physicians get paid for the new ways they use technology to advance patient care, other revised codes include:
  • Skin biopsy
  • Fine needle aspiration biopsy
  • Adaptive behavior analysis
  • Central nervous system assessments, including psychological and neuropsychology testing

Among the changes in the 2019 CPT code set are three new remote patient monitoring codes that reflect how health professionals can more effectively and efficiently use technology to connect with their patients at home to gather data for care management and coordination.


  • 99453Remote monitoring of physiologic parameter(s), (for example, weight, blood pressure, pulse oximetry, respiratory flow rate) initial; setup and patient education on equipment use
  • 99454Device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days
  • 99457Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month
  • There also are two new interprofessional internet consultation codes to reflect the increasing importance of using non-verbal communication technology to coordinate patient care between a consulting physician and treating physician.


  • 99451 Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician, including a written report to the patient’s treating/requesting physician or other qualified health care professional, 5 minutes or more of medical consultative time
  • 99452 Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional, 30 minutes

Broad input from practicing physicians, medical specialty societies and the greater health care community was considered by the CPT Editorial Panel to produce the latest practical enhancements to CPT that reflect the coding demands of the modern health care system. (CMS website link)