On June 16, the Centers for Medicare and Medicaid Services (CMS) announced the ICD-10 Code changes for the fiscal year (FY) 2024. These updates will come into effect on October 1, 2023. Our medical billing company stays up to date on annual coding updates to assist physicians in accurately billing for their services.

The ICD-10 code set update for 2024 includes 395 new ICD-10 codes, 25 deletions, and 22 revisions (nine of which are to the short title only). Several new codes have been added throughout the code set to improve specificity for known conditions. There are also 131 new headers four revised headers and updates to the 2024 addendum, code descriptions in tabular order, and code tables, tabular list, and index. Most of the changes to the diagnosis coding guideline changes for FY 2024 are chapter specific. Let’ s take a look at some of these important ICD-10 code and guideline updates:

• 24 new codes in the diseases of the nervous system (G00-G99) chapter
• 34 new codes in diseases of the eye and adnexa (H00-H59) chapter
• 36 new codes in diseases of the musculoskeletal system and connective tissue (M00-M99) chapter
• 22 new codes added and six revised in the congenital malformations, deformations and chromosomal abnormalities (Q00-Q99) chapter
• 30 new codes added to and six invalidated from the factors influencing health status and contact with health services (Z00-Z99) chapter
• Five new codes for Parkinson’ s disease:

  G20.A1, Parkinson’ s disease without dyskinesia, without mention of fluctuations
  G20.A2, Parkinson’ s disease without dyskinesia, with fluctuations
  G20.B1, Parkinson’ s disease with dyskinesia, without mention of fluctuations
  G20.B2, Parkinson’ s disease with dyskinesia, with fluctuations
  G20.C, Parkinsonism, unspecified

• New codes underCertain Infectious and Parasitic Diseases; one new code to note: A41.54 Sepsis due to Acinetobacter baumannii
• The ICD 10 code for familial adenomatous polyposis (FAP) is D12.6. A new code has been added to capture benign neoplasms elsewhere in the digestive system
• New Z codes to report family history of FAP
• D13.9 (Benign neoplasm: Ill-defined sites within the digestive system) is revised to D13.99 for a handful of applicable body areas
• New codes for desmoid tumors (D48.11-)
• New codes for other specified neoplasms of uncertain behavior of connective and other soft tissue (D48.19)
• Under Diseases of Blood, there are several additions and revisions for reporting sickle-cell disorders.
• New codes for reporting Scwachman-Diamond syndrome (D61.02) and IgG4-related disease (D89.84), and many parenthetical revisions
• Under Endocrine, Nutritional, and Metabolic Diseases, there are new codes to identify individuals with Autosomal dominant hypocalcemia (ADH), a genetic disorder of calcium metabolism mediated by hypoparathyroidism
• New codes for reporting various lipid storage disorders and for improved reporting of leukodystrophies
• E74.05 is a new code for lysosome-associated membrane protein 2 [LAMP2] deficiency
• New codes E88.810-E88.819 to identify insulin resistant metabolic syndrome types A and B) and unspecified insulin resistance
• Under G43 Migraine, there are new subcategories and codes for reporting chronic migraine and differentiating whether the pain is manageable.
• New codes for other hypertension (I1A-) and inappropriate sinus tachycardia (I47.10-I47.19).
• Addition of a new subcategory and new codes to identify bronchiolitis obliterans and bronchiolitis obliterans syndrome.
• New codes for acute appendicitis (K35.200-K35.211, K35.219), disorders of the retroperitoneum (K68.2-K68.3), short bowel syndrome (SBS) with or without continuity between the short bowel and colon (K90.821-K90.822, K90.829), and intestinal failure (K90.83)
• New codes under new subcategories M80.0B Age-related osteoporosis with current pathological fracture and M80.8B Other osteoporosis with current pathological fracture, pelvis
• New codes under N02.B Recurrent and persistent immunoglobulin A nephropathy to indicate the severity or course of IgAN
• New codes are added under categories N04 Nephrotic syndrome and N06 Isolated proteinuria with specified morphological lesion
• New codes O26.64- for the reporting of intrahepatic cholestasis in pregnancy
• New codes in the external causes of morbidity (V00-Y99) chapter to capture accidents and injuries, such as:

W44.A1XA, Button battery entering into or through a natural orifice, initial encounter
W44.C0XA, Glass unspecified, entering into or through a natural orifice, initial encounter.
W44.H2XD, Knife, sword or dagger entering into or through a natural orifice, subsequent

Changes to ICD-10 Coding Guidelines

Here are some key new guidelines for ICD-10 FY 2024 as listed in a recent AAPC article:

• Screening for COVID-19: Code Z11.52 should be assigned for COVID-19 screening encounters on or after Oct. 1, 2023.

The following guideline is added: “For screening for COVID-19, including preoperative testing, assign code Z11.52, Encounter for screening for COVID-19.”

• Myocardial Infarction with Coronary Microvascular Dysfunction: New ICD-10 code I21.B describes myocardial infraction with coronary microvascular disease and myocardial infarction with nonobstructive coronary arteries (MINOCA) with microvascular disease. The FY 2024 ICD-10 guideline states:

“Coronary microvascular dysfunction (CMD) is a condition that impacts the microvasculature by restricting microvascular flow and increasing microvascular resistance. Code I21.B, Myocardial infarction with coronary microvascular dysfunction, is assigned for myocardial infarction with coronary microvascular disease, myocardial infarction with coronary microvascular dysfunction, and myocardial infarction with non-obstructive coronary arteries (MINOCA) with microvascular disease.”

• Coma
• Code R40.20, Unspecified coma, should be assigned when the underlying cause of the coma is not known, or the cause is a traumatic brain injury and the coma scale is not documented in the medical record.
• Do not report codes for unspecified coma, individual or total Glasgow coma scale scores for a patient with a medically induced coma or a sedated patient.
• Coma scale codes (R40.21- to R40.24-) can be used in conjunction with traumatic brain injury codes. These codes cannot be used with code R40.2A, Nontraumatic coma due to underlying condition. They are primarily for use by trauma registries, but they may be used in any setting where this information is collected. The coma scale codes should be sequenced after the diagnosis code(s).”
• Newly added code R40.2A also describes secondary coma. A parenthetical note in the ICD-10-CM code book instructs you to code first the underlying condition.

• Follow-up: The guideline states:”Codes Z08, Encounter for follow-up examination after completed treatment for malignant neoplasm, and Z09, Encounter for follow up examination after completed treatment for conditions other than malignant neoplasm, may be assigned following any type of completed treatment modality (including both medical and surgical treatments).”

• Reporting Additional Diagnoses: Under Reporting Additional Diagnoses, the words “clinically significant” have been added to the guideline: “For reporting purposes, the definition for ‘other diagnoses’ is interpreted as additional clinically significant conditions that affect patient care in terms of requiring …”

This is just an overview of the diagnosis coding changes for FY 2024. In reliable medical billing companies, the medical coding team carefully examines annual code updates to ensure accurate reporting of patient conditions and encounters. By staying up-to-date with these updates, billing companies guarantee that the codes utilized for medical procedures, diagnoses, and services adhere to the latest guidelines, thus preventing billing errors and reducing claim denials. This dedication to accuracy ultimately ensures that physicians receive rightful reimbursement for the services they render.