What are ICD-10 Codes and How do They Work?
The ICD-10-CM code system uses a three to seven-character format for diagnostic codes in Medical Coding. The seventh character is a sequence of letters that identify a specific circumstance relating to the diagnosis or treatment of a patient. Depending on the severity of the condition, ICD-10 codes are composed of three to seven characters. The higher the number of characters, the more specific the diagnosis is. Alpha characters make up the first character, while the second to seventh characters are numeric. There are three-character categories that can stand alone as codes. These are also more specific and allow for greater specificity. The ICD-10 code set was first adopted by the World Health Organization in 1993. It has more specificity than ICD-9 codes. It also reflects critical advances in science and medication. However, ICD-9 codes are still used.
ICD-10 codes have become a common tool for health care providers, you need to know how to use them correctly when working in Medical Coding. Using the wrong codes may result in rejections from insurance companies. The ICD-10 codes are essential to the medical industry and mistakes can lead to the denial of claims. It is also important to understand that each code has a meaning. This is why it is crucial to refer to the codes when reviewing the medical records. If you notice a code that seems a bit different, research it.
The AAPC Updates ICD-10 Codes Yearly
Every year, new codes, revisions and deletions are made to the ICD-10 Code System. These revisions are reviewed by the ICD-10 Coordination and Maintenance Committee. The committee then passes on the recommended revisions to the Department of Health and Human Services. The lead agency for ICD-10-CM is the National Center for Health Statistics, while the Centers for Medicare and Medicaid Services is responsible for ICD-10-PCS. The AAPC updates ICD-10 codes yearly to reflect the latest changes in medical diagnosis.
The 2023 ICD-10 code changes affect a variety of diagnoses and procedure codes. These changes include new codes for heart disease, Dementia, injuries sustained in motor vehicle collisions and much more. Also, there are new guidelines for pregnancy. In 2023, the AAPC added more than 1,400 new diagnosis codes. In addition, they revised 35 code descriptors and converted 36 codes to parent codes. 251 codes were deleted. The changes were in effect as of Oct. 1, 2022.
Here are some examples of the new changes through the years:
Social Determinants of Health
Social determinants of health are factors that influence an individual’s physical and mental health. They can affect the way a person receives care and how doctors spend their time to make the most informed decisions possible for patients to receive the proper care that they need. These Medical Codes are assigned to patients based on their self-reported documentation. However, providers must sign off on the information before assigning the code. These codes must be incorporated into the health record. There are some potential challenges associated with these changes and providers should be aware of them before implementing them. The new 2023 Social determinants of health changes are implemented in the Medicare Hospital Inpatient Prospective Payment System. The changes require hospitals to report their SDOH screenings and results.
New Dementia Codes
The addition of new dementia-related diagnoses, brain illness and injury. The new ICD-10 Medical Codes for dementia are grouped by etiology and severity. They are not intended to replace the current ICD-9-CM codes. However, they are intended to be more specific. For example, the new code F0150 will be used for vascular dementia without behavioral disturbance. Code F0280 will be used for unspecified dementia, and F0390 will be used for non-vascular dementia. Code I20.2 is a condition in which the disease has not responded to medical treatment.
Here are more of the changes:
|F01.A3 Vascular dementia, mild, with mood disturbance|
|F01.A4 Vascular dementia, mild, with anxiety|
|F01.B Vascular dementia, moderate|
|F01.B0 Vascular dementia, moderate, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety|
|F03.911 Unspecified dementia, unspecified severity, with agitation|
|F03.918 Unspecified dementia, unspecified severity, with other behavioral disturbance|
Endometriosis and Maternal Care
Maternal care and endometriosis received some updates to better reflect their respective conditions. 168 new endometriosis codes have been added to ICD-10-CM. These new codes include information about anatomic depth and laterality.
Here are some of the codes:
|N80.00 Endometriosis of the uterus, unspecified|
|N80.01 Superficial endometriosis of the uterus|
|N80.02 Deep endometriosis of the uterus|
|N80.03 Adenomyosis of the uterus|
|N80.10 Endometriosis of ovary, unspecified depth|
|N80.11 Superficial endometriosis of the ovary|
|N80.129 Deep endometriosis of ovary, unspecified ovary|
|N80.20 Endometriosis of fallopian tube, unspecified depth|
Pregnancy Code Changes
The ICD-10 code set for pregnancy has undergone a revision. The changes focus on fetal conditions and include 200 new codes for these conditions. These codes are more comprehensive and accurately represent the medical condition of the fetus. Additionally, several other chapters have seen significant changes.
|O35.03×5 Maternal care for (suspected) central nervous system malformation or damage in fetus, choroid plexus cysts, fetus 5|
|O35.04×0 Maternal care for (suspected) central nervous system malformation or damage in fetus, encephalocele, not applicable or unspecified|
|O35.05×2 Maternal care for (suspected) central nervous system malformation or damage in fetus, holoprosencephaly, fetus 2|
|O35.06×1 Maternal care for (suspected) central nervous system malformation or damage in fetus, hydrocephaly, fetus 1|
New Codes for Slipped Capital Femoral (SCFE)
Slipped Capital Femoral Epiphysis, also known as SCFE, is a common hip disorder in adolescence and preadolescence. In this disorder, the femoral head slips out of alignment with the rest of the bone, often for no apparent reason. The 2023 ICD10 code changes for sprained capital femoral epiphysis (SCFE) introduce a number of new and revised codes. These changes include expanded M93.0-code sets that have more five and six-character options and a larger scope for epiphysis. In addition, a new M code category was added for sternum and rib fractures associated with chest compression and cardiopulmonary resuscitation.
New Codes for Injuries Due to Motor Vehicle Collisions
Several Medical Codes were updated in ICD-10 with injuries due to motor vehicle collisions. The new codes for these conditions are based on ICD-10 codes for external causes of injury. The new codes also include more detailed descriptions of the conditions. The guidelines for the new codes can be found in tables 6A and 6C.
New Codes for Electrical Bike Accidents
The ICD-10 codes used in e-bike accidents are similar to those used in traditional bike accidents, with the exception that the ICD-10 system uses the letter “V” to indicate an external cause. The two-digit ICD code indicates the injured person and corresponding circumstance, the final decimal code specifies the type of injury.
The updated codes cover a variety of topics, including the injuries caused by e-bikes. New codes for poisoning, catching between moving and stationary objects, e-bike driver and passenger injuries are included. A new chapter also includes codes for non-compliance with safety regulations.
V20-V29 Electric (assisted)bicycle injury codes
Other changes include additional codes for the nervous system, cardiovascular, and musculoskeletal/connective tissue chapters. In addition, a few chapters will see coding changes related to factors influencing health status.
ICD-10 Code Series
|C84.4 Revisions to T-Cell Lymphoma codes|
|B37 New codes for Candidiasis of the vulva and vagina|
|D59.3 More specific codes for Hemolytic-Uremic Syndrome|
|D68.0 Expansion of Von Willebrand Disease codes|
|E34.3 New codes describing short stature|
|E87.2 Additional new acidosis codes|
|F10.9 New codes that describe the use of alcohol, opioids, cannabis, cocaine and other substances|
|G71.03 Codes added to describe Limb Girdle Muscular Dystrophy|
|125 Atherosclerosis category expansion|
|M62.5A New codes describing muscle wasting of the back|
|M93.0 Additional codes describing slipped upper femoral epiphysis|
|P28 New codes for newborn sleep disorders|
|791.1 Patient noncompliance with provider’s orders|
|S06.0XAA, concussion with loss of consciousness status unknown, initial encounter|
|S06.0XAD, concussion with loss of consciousness status unknown, subsequent encounter|
|S06.0XAS, concussion with loss of consciousness status unknown, sequela|
All ICD10 Medical Coding changes went into effect as of October 1, 2022. It is a good idea for all current Medical Coders and those working towards a certification to research and study the new 2023 ICD10 changes. As you can see, there are a substantial amount of changes and this blog only mentions some of them. It may take a little while to get used to. Do not get discouraged. It’s important to plan ahead and make sure you are properly trained.
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