Changes for ICD-10 documentation codes that go into impact in October 2022.

Question: What are the brand new documentation codes for 2023?

Answer: The Centers for Disease Control and Prevention (CDC) issued the 2023 ICD-10-CM code updates on June 9, 2022, which embody 1,176 new, 28 revised, and 287 deleted codes for use for affected person encounters and discharges occurring from October 1, 2022 by means of September 30, 2023. They apply to all insurers, whether or not you’re billing Medicare, Medicaid, Tricare or a business payor.So let’s breakdown the revisions, deletions, and additions that can assist you get ready.

New Dementia Codes

An enlargement of the dementia codes got here from a request within the Centers forDisease Control’s (CDC) September 2021 ICD-10-CM Coordination and Maintenance Committee Meeting, the National Minority Quality Forum (NMQF) requested an enlargement of the dementia codes to incorporate the stage and severity and identification of behavioral and psychological signs of dementia.According to the NMQF, “Both of these clinical elements are major factors in patient management strategies.”As a outcome, the 2023 ICD-10 code set now consists of practically 100 new codes associated to dementia.You’re now capable of report circumstances like vascular dementia (F01.5-F01.C4), dementia in different ailments (F02.8-F02.C4), and unspecified dementia (F03.9-F03.C4).

The new pointers for reporting dementia emphasize that suppliers should clearly doc the severity of the affected person’s situation. If the documentation is incomplete, the coder ought to question the supplier or default to the suitable unspecified code. The up to date pointers additionally instruct that if a affected person with dementia is admitted to an inpatient facility and will get worse throughout their keep, the coder ought to assign the very best severity stage reported in the course of the keep.

In the CDC meeting, the Committee gave the next clarifications to assist decide the dementia stage.

Mild dementia: “Clearly evident functional impact on daily life, affecting mainly instrumental activities. No longer fully independent/requires occasional assistance with daily life activities.”

Moderate dementia: “Extensive functional impact on daily life with impairment in basic activities. No longer independent and requires frequent assistance with daily life activities.”

Severe dementia: “Clinical interview may not be possible. Complete dependency due to severe functional impact on daily life with impairment in basic activities, including basic self-care.”

Just a few of the particular new dementia codes embody:

  • F02.811, dementia in different ailments labeled elsewhere, unspecified severity, with agitation
  • F02.A11, dementia in different ailments labeled elsewhere, gentle, with agitation
  • F02.B11, dementia in different ailments labeled elsewhere, average, with agitation

Endometriosis Code Expansions

For these suppliers who see sufferers for endometriosis or maternal care, there now are nearly 400 new codes representing ob-gyn circumstances. American College of Obstetricians and Gynecologists (ACOG) proposed an enlargement to the endometriosis part of the ICD-10-CM code set, and you’ll now see most of the new endometriosis codes with additional specificity to element whether or not the situation is superficial or deep. The definitions beneath will probably be important in selecting the proper code:

Superficial endometriosis: Ectopic development of endometrial-like tissue that extends 5mm or much less beneath the peritoneal floor. Lesions can fluctuate in quantity (singular or in a number of places).

Deeply infiltrating endometriosis: Ectopic development of endometrial-like tissue that extends higher than 5mm beneath the peritoneal floor. Lesions can fluctuate in quantity (singular or in a number of places). These lesions are generally related to deep fibrosis and adhesions.

If you don’t see the phrases “deep” or “superficial” within the doctor’s notes, then search for any indication of how far beneath the peritoneal floor the tissue prolonged. This will probably be important in choosing the fitting code beneath the brand new 2023 ICD-10-CM codes. For occasion, you’ll report superficial endometriosis of the fitting ovary with N80.111, and deep endometriosis of the fitting ovary will code to N80.121.

Fetal Anomalies

ACOG and the Society for Maternal Fetal Medicine (SMFM) additionally requested new codes for fetal anomalies (e.g. Central Nervous System Anomalies (CNS), Chromosomal Anomalies, and Fetal Abnormalities and Damage). According to those teams, “This proposal will enable better tracking, measurement, and ultimately improved treatment modalities for identified fetal anomalies.”

Loss of Consciousness Clarification

For concussion and mind damage codes (e.g., concussions, contusions, traumatic mind accidents, blast accidents and hemorrhages), greater than 100 new 2023 ICD-10-CM codes have been added within the S06 (Intracranial damage) vary.According to the American Academy of Pediatrics (AAP), sufferers typically current with accidents that code to the S06 class with out a clear historical past of lack of consciousness (LOC), so that they requested new codes to incorporate identification of the LOC and, if current, how lengthy it lasted.

With the LOC addition, you have to to know whether or not a affected person misplaced consciousness with a view to choose the proper prognosis code.For occasion, if a affected person had a lack of consciousness with a concussion, you’ll report a code from the S06.0XA sequence, whereas a main blast damage of the mind with lack of consciousness of half-hour or much less will code out to the S06.8A1 vary of codes.Here are some particular examples:

  1. S06.0XAA, concussion with lack of consciousness standing unknown, preliminary encounter
  2. S06.0XAD, concussion with lack of consciousness standing unknown, subsequent encounter
  3. S06.0XAS, concussion with lack of consciousness standing unknown, sequela

New Meth Overdose Codes

You will discover a new code class describing poisoning by methamphetamines, in addition to codes for hostile results referring to meth use. In the previous, coders reporting meth overdoses needed to report these companies from the overall “amphetamines” class, however use of that code made it difficult for public well being authorities to trace meth overdoses.

You’ll discover new codes on this class beneath the brand new T43.65 (Poisoning by, hostile impact of and underdosing of methamphetamines carried out as a result of self-harm or assault) vary. To report them precisely, you need to discover within the report whether or not the overdose was unintended, was, or if the standing is undetermined. These components will probably be important in permitting you to pick out the proper code.

Additional New Codes

In addition to the brand new 2023 ICD-10-CM codes outlined above, there are lots of code modifications impacting practically each specialty. Take a while to overview the next:

The CDC complete ICD-10-CM itemizing will be discovered here.

Renee Dowling is a compliance auditor for Sansum Clinic, LLC, in Santa Barbara, California.

Leave a comment

Your email address will not be published. Required fields are marked *