Medical Coding

ICD-10 Code Changes for 2024

Centres for Medicare & Medicaid Services (CMS) have announced significant changes to the ICD-10-CM code set for fiscal year 2024. Once again, it's that time of year. With hundreds of new and revised codes joining the code set this year as part of the ICD-10-CM annual revisions, there is a lot to understand as of October 1, 2023.

Oct 2, 2023

Learn about the most current 2024 ICD-10 Code Changes

Centres for Medicare & Medicaid Services (CMS) have announced significant changes to the ICD-10-CM code set for fiscal year 2024.

Once again, it's that time of year. With hundreds of new and revised codes joining the code set this year as part of the ICD-10-CM annual revisions, there is a lot to understand as of October 1, 2023.

 These proposed changes encompass the introduction of 395 new codes, the removal of 25 existing codes, and the modification of 22 codes. These changes will have a big impact on how healthcare institutions handle their Finances. ICD-10-PCS will introduce 78 new codes, revise 14 titles, and eliminate 5 codes.

Implications for the revenue cycle process

The revenue cycle of healthcare companies will be greatly affected by the changes to the ICD-10-CM code set in 2024. The updated and new codes will make it possible to document patients' medical conditions with greater accuracy, guaranteeing that the medical necessity of the services provided is satisfied. This is essential to raising claim success rates and reducing denials.

What has changed in the ICD-10-CM CODE SET for 2024?

Here are some specific modifications in the 2024 ICD-10-CM code set:

  • New codes are being introduced in several categories, such as Parkinson’s disease, osteoporosis with pathological fractures, chronic migraines, neoplasms and tumors, intrahepatic cholestasis of pregnancy, retinopathy, and codes to accurately describe external causes. A new category has been added: W44 Foreign body entering into or through a natural orifice for more serious objects such as glass (W44.C1), and button batteries (W44.A1).

  • In addition, a new code for acute appendicitis (K35.200-K35.211, K35.219)

  • Latest codes to identify insulin-resistant metabolic syndromes A and B: (E88.810-E88.819)

  • Numerous Z codes have been added to represent cases where caregivers don’t comply with a patient’s medication regimen, renal dialysis, and other medical treatments. For instance, Z91.A41 (Caregiver’s noncompliance with patient’s medication regimen due to financial hardship) is one such addition.

  • Additional new codes have been created to represent child-guardian relationships, such as Z62.23 (Child in custody of non-parental relative).

  • Examples of revised ICD-10-CM codes include I71.51, I71.52, I71.61, and I71.62, pertaining to supra-celiac and paravisceral aneurysms of the abdominal aorta with or without rupture. The term “abdominal aorta” has been updated to specify “thoracoabdominal aorta.” These revisions ensure that healthcare organizations accurately bill for the precise anatomical location of the aneurysm.

New Neurology-Related Codes

ICD-10-CM 2024 introduces 24 new codes to Chapter 6: Diseases of the Nervous System.

Parkinson’s disease: The updates include five new codes to report Parkinson’s disease (G20), which will boost code specificity by adding information about dyskinesia and fluctuations.

  • G20.A- (Parkinson’s disease without dyskinesia)

  • G20.A1 (Parkinson’s disease without dyskinesia, without mention of fluctuations)

  • G20.A2 (Parkinson’s disease without dyskinesia, with fluctuations)

  • G20.B- (Parkinson’s disease with dyskinesia)

  • G20.B1 (Parkinson’s disease with dyskinesia, without mention of fluctuations)

  • G20.B2 (Parkinson’s disease with dyskinesia, with fluctuations)

  • G20.C (Parkinsonism, unspecified)

Note: G20 was the only code for Parkinson’s disease in the ICD-10-CM code book before 2024. These updates will make Parkinson’s coding more specific by adding information about dyskinesia and fluctuations

Chronic migraine with aura

Don’t miss the new codes under G43.E- (Chronic migraine with aura) for reporting chronic migraine:

  • G43.E0 (Chronic migraine with aura, not intractable)

  • G43.E01 (Chronic migraine with aura, not intractable, with status migrainosus)

  • G43.E09 (… without status migrainosus)

  • G43.E1 (Chronic migraine with aura, intractable)

  • G43.E11 (Chronic migraine with aura, intractable, with status migrainosus)

  • G43.E19 (… without status migrainosus)

Note: The new migraine codes add another layer to the already deep field of G43.- (Migraine) codes. Before 2024, chronic migraine with aura did not have its own code set. Starting Oct. 1, you’ll be able to code for chronic migraine with aura, and you can further specify that diagnosis by answering the intractable/not intractable and status migrainosus questions.

Examine External Causes ‘Foreign Body Entering Orifice’ Codes

Most of the diagnosis code additions fall under added category W44 (Foreign body entering into or through a natural orifice) in Chapter 20: External Causes of Morbidity. 

The expansion provides 123 new codes you can report to capture accidents and injuries involving foreign bodies — batteries, plastic objects, glass, magnetic and non-magnetic metal items, rubber bands, food, insets, audio device, etc. — that enter or pass through a natural orifice.

As with most external cause codes, you’ll add a 7th character to these new codes to indicate the type of encounter: A (... initial encounter), D (… subsequent encounter), or S (… sequela).

Regarding foreign bodies: ENT practices should also take note of the following additions under novel parent code R09.A- (Foreign body sensation of the circulatory and respiratory system):

  • R09.A0 (Foreign body sensation, unspecified)

  • R09.A1 (Foreign body sensation, nose)

  • R09.A2 (Foreign body sensation, throat)

  • R09.A9 (Foreign body sensation, other site)

Z Code Additions

  • Z codes, as you are aware, capture details that have a substantial impact on patient care and health outcomes, support medical necessity, and aid in the collection of information on the effectiveness of treatments and the true cost of care. That’s why Chapter 21: Factors Influencing Health Status and Contact with Health Services (Z00-Z99) is constantly expanding.

  • The 30 new Z codes encompass various aspects such as personal history of military service, newborn observation for suspected conditions ruled out, carriers of bacteria Acinetobacter baumannii, Enterobacterales), family history of certain colonic polyps, and caregiver noncompliance.

  • ICD-10-CM 2024 also enhances the SDoH section (Z55-Z65), providing you with more ways to report notable child-guardian relationships, thanks to new codes like Z62.23 (Child in custody of non-parental relative), Z62.823 (Parent-step child conflict), and Z62.832 (Non-relative guardian-child conflict).

Don’t miss: Other diagnosis code updates for FY 2024 include:

  • 21 new codes added to the neoplasms (D00-D89) chapter

  • 36 new codes added to the 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.

How can you get ready for the changes?

Healthcare institutions, RCM companies, and individual coders should all carefully evaluate the revisions to the ICD-10-CM code set that will take effect in 2024.

Review the changes: Every year, a list of all ICD code changes is released by the Centers for Disease Control and Prevention (CDC). This list is available on the CDC website. Review the list of changes carefully after you have it to determine what has been added, removed, or changed..

Educate yourself and your staff: After you have gained an understanding of the changes, it is crucial to teach your personnel how to put them into practice. This could be taking training sessions, learning about the changes through articles and books, or creating your own internal training resources.

Update your systems and procedures: The new ICD codes must be added to your electronic health record (EHR) system, if you use one, so that it is up to date. You might also need to alter your documentation standards and coding methods.

Test your systems and procedures: It's crucial to test your systems and processes to ensure they are operating effectively once you have made all the necessary adjustments. Running test cases or doing dummy audits are two ways to accomplish this.

Monitor the impact of the changes: Following the implementation of the new ICD codes, it's crucial to keep an eye on how they're affecting your business. Tracking coding errors, rejections, and appeals may be necessary for this.

By following these steps, healthcare organizations can smoothly transition to the 2024 ICD-10-CM code set changes, ensuring the stability of their revenue cycle.

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