New ICD-10 codes you should know before October

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Changes to ICD-10 documentation codes effective October 2022.

Question: What are the new documentation codes for 2023?

Answer: The Centers for Disease Control and Prevention (CDC) issued the ICD-10-CM Code 2023 Update on June 9, 2022, containing 1,176 new, 28 revised, and 287 deleted codes used for patient contacts and discharges from October 1, 2022 to September 30, 2023. They apply to all insurers, whether you’re billing Medicare, Medicaid, Tricare, or a commercial payer. So let’s break down the revisions, deletions, and additions to help you prepare.

New dementia codes

An expansion of dementia codes came from a September 2021 request from the Centers for Disease Control (CDC). ICD-10-CM Coordination and Maintenance Committee Meetingthe National Minority Quality Forum (NMQF) called for an expansion of dementia codes to include stage and severity, and identification of behavioral and psychological symptoms of dementia.” As a result, the ICD-10 2023 code set now includes nearly 100 new related codes with dementia. You can now include conditions such as vascular dementia (F01.5-F01.C4), dementia associated with other diseases (F02.8-F02.C4), and non-specific dementia (F03.9-F03.C4).

The new guidelines for reporting dementia emphasize that providers must clearly document the severity of the patient’s condition. If the documentation is incomplete, the coder should consult the vendor or default to the appropriate unspecified code. The updated guidelines also instruct that if a patient with dementia is admitted to an inpatient facility and worsens during their stay, the coder should assign the highest severity level reported during the stay.

In which CDC meetingthe committee provided the following explanations to help determine the stage of dementia.

Mild dementia: “Clearly recognizable functional influence on daily life, affecting mainly instrumental activities. No longer fully independent/needs occasional assistance with activities of daily living.”

moderate dementia: “Extensive functional impact on daily living with impairment of basic activities. No longer independent and requires frequent assistance with activities of daily living.”

Severe dementia: “A clinical interview may not be possible. Total dependency due to severe functional impact on daily living with impairment of basic activities, including basic self-care.”

Some of the specific new dementia codes include:

  • F02.811, Dementia in other diseases classified elsewhere, unspecified grade, with agitation
  • F02.A11, Dementia with other diseases classified elsewhere, mild with agitation
  • F02.B11, Dementia in other diseases classified elsewhere, moderate with agitation

Endometriosis Code Extensions

For providers who see patients for endometriosis or maternal care, there are now nearly 400 new codes representing gynecologic disorders. The American College of Obstetricians and Gynecologists (ACOG) has proposed an expansion of the endometriosis section of the ICD-10-CM code set, and you will now see many of the new endometriosis codes with further specification of whether the condition is superficial or deep. The following definitions are critical to choosing the right code:

Superficial endometriosis: Ectopic growth of endometrial-like tissue extending 5 mm or less below the peritoneal surface. The number of lesions can vary (single or in multiple places).

Deep infiltrating endometriosis: Ectopic growth of endometrial-like tissue extending more than 5 mm below the peritoneal surface. The number of lesions can vary (single or in multiple places). These lesions are often associated with deep fibrosis and adhesions.

If you can’t find the terms “deep” or “superficial” in the doctor’s notes, look for clues as to how far the tissue extends below the peritoneal surface. This will be crucial when choosing the right code among the new 2023 ICD-10-CM codes. For example, report superficial right ovary endometriosis with N80.111 and deep right ovary endometriosis with N80.121.

Fetal abnormalities

ACOG and the Society for Maternal Fetal Medicine (SMFM) also called for new codes for fetal abnormalities (eg, central nervous system (CNS) abnormalities, chromosomal abnormalities, and fetal abnormalities and defects). According to these groups, “This proposal will allow for better tracking, measurement, and ultimately improved treatment modalities for identified fetal abnormalities.”

loss of consciousness Enlightenment

Added more than 100 new 2023 ICD-10-CM codes in S06 for concussion and brain injury codes (e.g. concussion, contusion, traumatic brain injury, blast injury and hemorrhage) (intracranial injury)-Area. According to the American Academy of Pediatrics (AAP), patients often present with injuries classified as S06 category without a clear history of loss of consciousness (LOC). So they requested new codes to identify the LOC and, if any, how long it took.

With the addition of LOC, you need to know if a patient has lost consciousness in order to select the correct diagnosis code. For example, if a patient has passed out due to concussion, enter a code from the S06.0XA series, whereas a primary blast brain injury with loss of consciousness of 30 minutes or less would be coded into code range S06.8A1. Here are some specific examples:

  1. S06.0XAA, concussion with loss of consciousness status unknown, first encounter
  2. S06.0XAD, concussion with loss of consciousness status unknown, subsequent encounter
  3. S06.0XAS, concussion with loss of consciousness status unknown, sequelae

New meth overdose codes

You’ll find a new code category describing methamphetamine poisoning, as well as codes for adverse effects associated with meth use. In the past, programmers reporting meth overdoses had to report those services under the general “amphetamines” category, but using this code made it harder for public health officials to track meth overdoses.

New codes can be found in this category under the new T43.65 (Methamphetamine poisoning, adverse reaction, and underdosing due to self-harm or physical harm) Offer. To report them accurately, you should review the records to determine if the overdose was accidental, was, or the status is undetermined. These factors are essential to help you choose the right code.

Additionally New codes

In addition to the new 2023 ICD-10-CM codes described above, there are many code changes affecting almost all subject areas. Take some time to check the following:

The CDC’s comprehensive ICD-10-CM list can be found here here.

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

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