Disclaimer

All the details shared in this report are best of our knowledge (MTServices) but there could always be mistakes.
Dash sign ( _ ) you see trailing the codes in this report is further description of or categories such as A for initial encounter, D= Subsequent encounter/routing healing etc. which are left blank intentionally.

Unlike previous years, this year there have been 2 updates. April/2023 updates and October/2023 ICD (International classification for disease codes). This ICD-10-CM 2024 updates covers the discharges and patient encounters from 1st of October/2023 till 30th of September/2024 if there no Further April/2023 updates in between.

What are ICD-10-CM Codes?

ICD-10-CM codes are developed by WHO (World Health Organization) as an international language for health statistics. All potential illnesses, injuries, and causes of mortality are coded on a map of the human condition from conception to death. Almost all healthcare decisions made today are based on these health statistics as ICD 10 CM are the codes which are determined based on diagnosis and CMA defines that this Version is US specific.

What’s Changed!

Compared to last year, this year changes are not that significant as we have only 395 New codes, with 22 Revised codes, and 25 deleted codes. 25 deleted codes basically are more accurately converted to parents code because they were expanded and needed additional characters, so they were not outrightly deleted but they needed an additional character and that is why you see here 25 – converted to parent codes.

Guidelines Changes:

Documentation by clinician other the patient provider:

In previous rules, people other than the patient’s provider were allowed to record certain things in patient record and we could abstract those codes but now there is minor clarification to that in regards to Social determination of health (SDOH). SDOH can be documented by other than the patient’s provider. The exception and clarification is that they have to be classified specifically to chapter 21 including all codes for SODH.

Guidelines for chapter 1 is slightly changed, T codes are to be used on Sepsis after post procedure wound and if the patient is OB (obstetrics) then O codes takes precedence followed by additional Sepsis code following a procedure which is T81.44 or Sepsis following an OB procedure O86.04.

Covid 19 Screening

Screening for Covid 19 including the preoperative test before surgery to make sure they do not have Covid 19 and for that we will assign Z11.52 per encounter for Covid 19 screening.

Resistant Hypertension

Chapter 9 has been revised in guidelines. There is new code for resistant hypertension (Blood pressure remains high even after medicine) which is I1A.0. But this is an extra code, and we have to code first the existing hypertension and then use the I1A.0.

Coma

Coma 1.1

Some of the Additions to Coma Guidelines. This means if we know the Coma scale or if patient is in medically induced coma or sedated state, we should not use the unspecified code. So R40.20 is only for when the cause is not known or the code is Traumatic brain injury and the coma scale is not documented.

Coma 1.2

This clarification on Coma Guidelines state that we should not use the Coma scale code when the patient has a non-Traumatic coma due to a under lying condition. So if you are using R40.2A, do not use the Coma Scale code.

Follow up

Let’s say someone is done with his cancer treatment, we will use the code Z08 and if encounter is for other conditions, for other follow up examination after they have completed the treatments for conditions other than a cancer we will use a Z09 codes.

Code Changes:

Chapter 1 – (2 New codes):
A41.54 and B96.83

These two codes are for different type of infections, bacterial infections, as bacterial infections are everywhere, like they are In soil, water and it can infect different parts of your body, blood, lungs etc. Sometimes it exists In your system without causing harm but when it is resistant to antibiotics, it can be problematic.

Chapter 2 – (13 new codes):
D13.91 , D13.99, D48.110, D48.111, D48.112, D48.113, D48.114, D48.115, D48.116, D48.117, D48.118, D48.119, D48.19.

D13.91 deals with Colon cancer due to family/genetic history which makes one prone to it including a lot of Colon polyps. There are three types, Classic, animated and autosomal recessive. D13.99 cancerous condition in digestive system and from D48.111 to D48.119 in Decimal tumor in different parts of the body and D48.19 is for unspecified code.

Chapter 3 – (8 New codes):
D57.04, D57.214, D57.414, D47.434, D57.454, D57.B14, D61.02, D89.84

These relates to Sickle cell thalassemia. So when we have Sickle cell hemoglobin, that causes the Reb blood cells to become sickle shape under stress, like low oxygen, and then these sickle cells can block vessels and can cause pain and other complications. If you have Beta Zero, which means no hemoglobin is produced and beta plus there is some normal Hemoglobin produced. Shwachman diamond syndrome – which is a rare genetic disorder affecting the bone marrow pancreas and skeleton which leads to weekend immune system and it’s chrono infections and other abnormalities. IgG4 related disease – a complex issue affects a multiple parts of the body. It’s an immune mediated condition characterized by tissue information and elevated level of certain antibodies and this disease can target any organ, liver, kidney, pancreas.

Chapter 4 – (18 New codes):
E20.810, E20.811, E20.812, E20.818, E20.819, E20.89, E74.05, E75.27, E75.28, E79.81, E79.82, E79.89, E88.43, E88.810, E88.811, E88.818, E88.819, E88.A

We have new codes for genetic disorder affecting calcium metabolism (ADH) and comes in two types, mutations in either the CASR or GNA 11 genes and leads to body misinterpreting how low the level of calcium is. New codes aims to improve the tracking and treatment of ADH and other types of Hypothyroidism like those associated with cancer or autoimmune conditions. The global Leukodystrophy alliance proposed the to have new codes created for different types of Leukodystrophies. Right now we have codes added for 6 main types for Leukodystrophy and probably more close to 400 will reflect in ICD 11.
We also saw new code for metabolic syndrome. Metabolic syndrome incudes factor like high blood pressure, high blood sugar, excess fat around the abdomen and abnormal cholesterol levels.
Few new codes to specify types of insulin resistance and last one we have wasting disease, since wasting disease means if the patient has lost more then 10% of body weight and muscle mass which is usually due to underlaying chronic disease and it can mean the disease has reached the severe level so national center for health statistics requested a specific code for wasting disease.

Chapter 5- No changes

Chapter 6 – (24 new codes):
G11.5, G11.6, G20.A1, G20.A2, G20.B, G20.B1, G20.B2, G20.C, G23.3, G31.80, G31.86, G37.81, G37.89, G40.C01, G40.C09, G40.C11, G40.C19, G43.E01, G43.E11, G43.E19, G90.B, G93.42, G93.43, G93.44

Deals with leukodystrophy codes. Here codes are added for types of leukodystrophy that impact the nervous system. Parkinson disease has been expanded for with and without Dyskinesia. Hypomyelination, that affects the central nervous system, now assigned to G23.3 code. Then there was a request from the Wisconsin physicians service corporation for a new ICD 10 CM code for specific chronic migraine with aura. These news codes add more specificity for the treatment and research for those individuals chronic migraines with Aura.

Chapter 7 – (12 New codes):
H36.81_, H36.82_, H36.89_, H50.62_, H50.63_, H50.64_, H50.65_, H50.66, H36.67_, H36.68_, H54.512, H57.8A_.

American Academy of Ophthalmology and American association of oral and Maxillofacial surgeons proposed new codes for proliferative sickle cell retinopathy. This condition can lead to vision impairment and blindness and then we have a new section of code regarding muscle entrapment and extraocular muscle entrapment is a condition more common in pediatric trauma. The aim of these news codes is to provide you better research for treatment and the proposal recommends adding unspecified to the subcategory of age 50.68 for more accurate coding and some codes for low vision of the right eye category 2 and foreign body sensation of the eye.

Chapter 8 – No Changes:

Chapter 9 – (10 New codes):
I1A.0, I20.81, I20.89, I21.B, I24.81, I24.89, I25.85, I47.10, I47.11, I47.19.

We have new code for Resistant hypertension and news codes in regards to coronary microvascular dysfunction. Abbot Laboratories propose these specific codes to improve the diagnosis and treatment. There is also a modification to the code title for inappropriate sinus tachycardia by adding a this little tiny statement here that says “ So stated” in the end. So the code changed from I47.1 to I47.11 and then in the end we have the I47.19 which is unspecified code if the provider only states SV tachycardia.

Chapter 10 – (7 New codes):
J15.61, J15.69, J44.81, J44.89, J4A.0, J4A.8, J4A.9

In 2017 Carbapenem-resistant Acinetobacter led to an estimated 8500 infections and 700 deaths in the US. Based on internal CBC review. So we have new codes in this chapter to reflect this. We also have additions to Bronchitis and COPD codes including and other specified COPD J44.89. There are also some Allograft related lung illness were added J4A.0 restrictive allograft syndrome and the other lung related diagnosis.

Chapter 11 – (18 New codes):
K35.200, K35.201, K35.209, K35.210, K35.211, K35.219, K35.821, K63.821, K63.8211, K63.8212, K63.8219, K63.822, K63.829, K68.2, K68.3, K90.821, K90.822, K90.829, K90.83.

This year good number of digestive system codes (6 new codes – K35) are added Such as Acute appendicitis with generalized peritonitis with additional conditions such with or without abscess and small intestinal bacterial over growth (6 New codes – K63) and this gut overgrowth can lead to different conditions such as bloating, abdominal pain, diagnosis typically involve breath test or intestinal samples and treatment options include targeted antibiotics or antifungals. Other codes added are Retroperitoneal codes ( 2 New codes – K68). Also new codes for Bowl syndrome ( 2 new codes with 2 different conditions and then 1 unspecified one and last code added are for intestinal failure ( 4 new codes - K90).

Chapter 12 – No changes:

Chapter 13 – (6 New codes):
M80.0B1_, M80.0B2_, M80.0B9_, M80.8B1_, M80.8B2_, M80.8B9_

These 6 codes expanded in Chapter 13 in regards to orthopedic procedures. Current ICD 10 CM codes inaccurately categories these as Femur Fractures which makes some impact on clinical decision so the AHRQ proposed new and more accurate coded that specifically say that they are related to age related osteoporosis with a current pathological fracture of the pelvis to improve the diagnosis and treatment and the blank space ( _ ) in the end of each code for the categories such as A for initial encounter, D= Subsequent encounter/routing healing etc.

Chapter 14 – (15 New codes):
N02.B1, N02.B2, N02.B3, N02.B4, N02.B5, N02.B6, N02.B9, N04.20, N04.21, N04.22, N04.29, N06.20, N06.21, N06.22, N06.29

The Renal physician association advocated for new ICD 10 CM codes for Immunoglobulin A nephropathy ( a common kidney disease). Adding of these codes for additional specificity allows for better patient care as the IGAN is diagnosed via renal biopsy and has specific therapies for treatment. New code also added for specification of different types and specifications of nephropathy.

Chapter 15 – (6 New codes)
O26.641, O26.642, O26.643, O26.649, O90.41, O90.49

These are O codes, which we know take precedence over all other codes. The American college of Obstetricians and Gynecologist ACOG said that they needed new codes for intrahepatic cholestasis (ICP) in pregnancy which is a liver disorder and half of the pregnancy percent in US is affected by this.

Chapter 16- No changes.

Chapter 17 – (16 New codes):
Q44.70, Q44.71, Q44.79, Q75.00_, Q75.01, Q75.02_, Q75.03_, Q75.04_, Q75.051, Q75.052, Q75.058, Q75.08, Q87.83, Q87.84, Q87.85, Q93.52

We see handful of new codes in this chapter. For example, Allagille syndrome is genetic disorder with varying symptoms such as jaundice, poor weight, heart defects. Currently it is grouped under a broader liver malformation code so they needed this code to improve patient care, clinical practice etc. and was proposed by Global liver institute. In this chapter new codes were added for Craniocentesis. Then we have at the very bottom MED 13L syndrome and that is genetic disorder affecting over mullion people world wide and foundation pushed for new code for this and lastly Q93.52.

Chapter 18 – (10 New codes):
R09.A0, R09.A1, R09.A2, R09.A9, R40.2A, R92.30, R92.31_, R92.32_, R92.33_, R92.34_

This year we have a lot of code added for specified foreign bodies entering through orifices and we have codes when we have the sensation of having a foreign body but it is not actually there (when we try look and find the foreign body but is not found on inspection) so instead of having no code or the worried well diagnosis now we have specified diagnosis for those in this chapter (foreign body sensation unspecified, nose and throat, other site). We also have new non-traumatic coma code which and several new codes for the density of the breasts because dense breath can impact mammogram reading so now we have these combined codes that are saying that patient coming for mammogram and specify that they have dense breast and give some specific information so that helps improve the data accuracy there as far as those screening codes.

Chapter 19 – (4 New codes):
T56.821_, T56.821_, T56.821_, T56.821_

We have few new codes for Toxic effects of Gadolinium- a chemical element used in different MRIs, and it can cause different common and uncommon side effects.

Chapter 20 – (41 New codes):
W44.8XX_, W44.9XX_, W44.A0X_, W44.A1X_, W44.A9X_, W44.B0X_, W44.B1X_, W44.B2X_, W44.B3X_, W44.B4X_, W44.B5X_, W44.B9X_, W44.C0X_, W44.C1X_, W44.C2X_, W4.D0X_, W44.D1X_, W44.D2X_, W44.D3X_, W44.D4X_, W44.D9X_, W44.E0X_, W44.E1X_, W44.E2X_, W44.E3X_, W44.E4X_, W44.E9X_, W44.F0X_, W44.F1X_, W44.F2X_, W44.F3X_, W44.F4X_, W44.F9X_, W44.G0X_, W44.G1X_, W44.G2X_, W44.G3X_, W44.G9X_, W44.H0X_, W44.H1X_, W44.H2X_,

The biggest change is in chapter 20 in External cause codes. These are related to mortalities, injuries due to foreign object such as water beads or Aqua beads which expand when ingested by child, magnets, button batteries. Major injuries are due to indigestion of Button batteries so there is an expansion of a lot of codes and American academy of pediatrics pushed for these codes since children were putting in metal objects, plastic toys into their ears, nose and mouth. So this chapter with new codes you can see different objects inserted or entered into through natural orifices, batteries, jewelries, plastic toys, rubber bands, insects etc.

Chapter 21 – (30 New codes):
Z02.84, Z05.81, Z05.89, Z16.31, Z22.340, Z22.341, Z22.349, Z22.350, Z22.358, Z22.359, Z29.81, Z29.89, Z62.23, Z62.24, Z62.823, Z62.831, Z62.832, Z62.833, Z62.892, Z62.710, Z62.711, Z62.718, Z62.719, Z91.85, Z91.A41, Z91.A48, Z91.A51, Z91.A58, Z91.A91, Z91.A98

Few codes added in Chapter 21 starting with Encounter for child welfare exam and treatment of Bacterial infection which is resistant to Antibiotics ( Carbapenem). There are new Z codes ( Z22.340 to Z22.358) they are for the status of someone who is carrier of these resistant bacteria. Also new codes for Encounter of HIV pre-exposure of prophylaxis and encounter for other prophylactic measures and new SDOH codes for child in custody of non parental relative etc. New code for patient run away from his current living environment and have new codes for family history of colon polyps and different types of colon polyps and the new code (Z91.85) for status for a patient with a personal history of military service.

Chapter 22 - No changes

 

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