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Additional Information: 2017 ICD-10-CM Diagnosis Code Update

October 5, 2016

A previously published Medi-Cal Update notified providers of the 2017 annual ICD-10-CM update to ICD-10-CM diagnosis codes. With the 2017 annual ICD-10-CM update, a number of diagnosis codes have been expanded for greater detail. Providers should use the new, expanded diagnosis codes when billing for dates of service on or after October 1, 2016.

Specific billing policy related to this update will be published in a future Medi-Cal Update. Inactivated ICD-10-CM diagnosis codes may still be listed as valid in the Medi-Cal Provider Manual. Until the Medi-Cal Provider Manual is updated, providers should use only valid ICD-10-CM diagnosis codes listed in the 2017 ICD-10-CM code book for dates of service on or after October 1, 2016.

For example, ICD-10-CM diagnosis code E08.331 is listed as a valid diagnosis when billing for CPT-4 code 92020 (gonioscopy) in the Professional Services: Diagnosis Codes section of the appropriate Part 2 manual.

The 2017 annual ICD-10-CM has expanded E08.331 to the following codes:

  • E08.3311
  • E08.3312
  • E08.3313
  • E08.3319

For dates of service before October 1, 2016, providers should continue to use E08.331 when billing for 92020. For dates of service on or after October 1, 2016, providers should use one of the four expanded codes. Billing with E08.331 for dates of service on or after October 1, 2016, will result in claim denial.