ICD-10 Code Updates Effective 10/1/2021


Every October, Office Practicum uses Health Language to access and update the complete list of Diagnosis Codes. It’s important to update templates, diagnostic tests, screenings, and favorites to include these new codes and remove those codes which are no longer valid.

Tip: Additional pediatric-specific resources for Practice Management provided by the AAP can be found here.

Abnormal Findings on Neonatal Screening (Invalidated, Replaced for Specificity)

P09, Abnormal findings on neonatal screening, is now invalid. The group has been expanded to include:

  • P09.1 Abnormal findings on neonatal screening for inborn errors of metabolism
  • P09.2 Abnormal findings on neonatal screening for congenital endocrine disease
  • P09.3 Abnormal findings on neonatal screening for congenital hematologic disorders
  • P09.4 Abnormal findings on neonatal screening for cystic fibrosis
  • P09.5 Abnormal findings on neonatal screening for critical congenital heart disease
  • P09.6 Abnormal findings on neonatal screening for neonatal hearing loss
  • P09.8 Other abnormal findings on neonatal screening
  • P09.9 Abnormal findings on neonatal screening, unspecified

Cough (Invalidated, Replaced for Specificity)

R05, cough, is now invalid. The expanded group includes:

  • R05.1 Cough, acute
  • R05.2 Subacute cough
  • R05.3 Cough, chronic
  • R05.8 Cough, other specified
  • R05.9 Cough, unspecified

Feeding Difficulties (Invalidated, Replaced for Specificity)

R63.3, feeding difficulties is invalid and this series now requires a fifth character:

  • R63.30 Feeding difficulties, unspecified 
  • R63.31 Pediatric feeding disorder, acute 
  • R63.32 Pediatric feeding disorder, chronic
  • R63.39 Other feeding difficulties

Immunization Safety Counseling (New Code Added)

Z71.85 Encounter for immunization safety counseling has been added: 

  • Use this code when reporting counseling provided to patients and caregivers who are vaccine-hesitant, wish to follow an alternative immunization schedule or otherwise require time spent in counseling at lengths beyond that which is typical of routine immunization counseling. Code Z71.85 may be reported to indicate the principal or first-listed reason for an encounter or as a secondary reason.
  • Code Z71.85 offers the opportunity to report efforts to educate and/or persuade patients and caregivers of the benefits of timely immunization. Code Z23 is sufficient for reporting immunization counseling when the patient receives the recommended immunizations without extended counseling on vaccine safety.

Note: CPT code 99401, preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes may be appropriate in this context. Be sure to understand the payer’s policy regarding this code and understand it is often not payable when used in the context of other preventive services including Well Visits.

Major Depressive Disorder (Invalidated, Replaced for Specificity)

F32.9, major depressive disorder, single episode, unspecified has been invalidated and replaced by F32.A depression, unspecified. A diagnosis of despondency is also reported with code F32.A. In addition, the F32 category is changed from “Major depressive disorder, single episode” to “Depressive episode,” as those patients who have an unspecified depression are not diagnosed with major depressive disorder.

Suicidal Behavior and Non-Suicidal Self-Harm (New Codes Added)

Codes for Suicidal Behavior and Non-suicidal Self-harm have been added:

  • R45.88,  Non-suicidal self-harm is added to differentiate self-harm without suicidal intent (eg, self-cutting as a coping mechanism) from self-harm with suicidal intent.
  • Z91.5 can no longer be reported without a fifth character. More granular codes include:
    • Z91.51, Personal history of suicidal behavior 
    • Z91.52, Personal history of non-suicidal self-harm