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A new code, I1A.0, was added to Chapter 9 for Resistant hypertension, defined as a condition where a patient’s blood pressure remains above goal despite concurrent use of at least three antihypertensive drugs of different pharmacological classes. The code descriptions under I71.51 (Supraceliac aneurysm of the abdominal aorta, ruptured) and I71.52 (Paravisceral aneurysm of the abdominal aorta, ruptured) are proposed to be revised to “Supraceliac aneurysm of the thoracoabdominal aorta, ruptured” and “Paravisceral aneurysm of the thoracoabdominal aorta, ruptured.” For example, Z91.A4 (Caregiver’s other noncompliance with patient's medication regimen) would become invalid and coders would use Z91.A41 (Caregiver's other noncompliance with patient’s medication regimen due to financial hardship) and Z91.A48 (Caregiver's other noncompliance with patient's medication regimen for other reason). Proposed changes would create two codes that indicate that the noncompliance is due to financial hardship or another reason.

You will also see expansion of the three caregiver’s other noncompliance codes that went into effect Oct. Personal history of military service no longer appears in the documentation guidelines for E/M services, but proposed ICD-10-CM code Z91.85 (Personal history of military service) would make it possible for practices to include this information. The four proposed codes follow the same format as the existing G codes for chronic migraine without aura: not intractable or intractable and with or without status migrainosus. The proposed rule would add chronic migraine with aura to the code set. Code E88.81 (Metabolic syndrome) would become invalid and be replaced with E88.810 (Metabolic syndrome), E88.811 (Insulin resistance syndrome, Type A), E88.818 (Other insulin resistance) and E88.819 (Insulin resistance, unspecified). Insulin resistance will have three distinct codes, according to the proposed rule. The proposed rule adds 14 codes for sickle cell anemia and related conditions, including D57.434 (Sickle-cell thalassemia beta zero with dactylitis) and H36.813 (Nonproliferative sickle-cell retinopathy, bilateral).