ICD-10-CM annual updates for 2022-2023

It’s that time of year again when the updates to the ICD-10-CM code set become effective and provider organizations across the country rush to learn about the changes and implement them on time. This year, 1,176 new billable codes were added to ICD-10-CM, dozens more revised, and a couple hundred deleted. Here are some details on a few of the code changes.

Chapter-specific changes  

While not all the chapters had changes, the following major changes were noted:  

• Chapter 3: Diseases of the blood and blood-forming organs and immune system (D50-D89) 
  • The addition and expansion of several thrombocytopenic disease categories. 
• Chapter 5: Mental, behavioral and neurodevelopmental disorders (F01-F99) 
  • New codes now allow for greater specificity in reporting dementia, substances abuse in remission, severe stress and prolonged grief disorders. 
• Chapter 9: Circulatory system (I00-I99) 
  • Higher specificity codes are now available for reporting angina, atherosclerosis, aneurysms, abnormal heart rhythms and vasculitis. 
• Chapter 13: Diseases of the musculoskeletal system and connective tissues (M00-M99) 
  • Intervertebral disc (annulus) defects, muscle wasting, slipped femoral epiphysis and fractures associated with chest compressions from CPR. 
• Chapter 14: Genitourinary system (N00-N99) 
  • Expanded coding for Fournier disease and endometriosis. 
• Chapter 15: Pregnancy, childbirth and the puerperium (O00-O9A)  
  • Significant expansion in codes for reporting maternal care for suspected central nervous system (CNS) damage, chromosomal abnormalities and other abnormalities and damage in the individual fetus. 
• Chapter 19: Injury, poisoning and certain other consequences of external causes (S00-T88)  
  • Higher specificity coding for various traumatic brain and carotid artery injuries, as well as injuries related to methamphetamines. 
• Chapter 20: External causes of morbidity (V00-Y99) 
  •  A significant number of new codes were added to this chapter, for reporting injuries to the driver or passenger involved in an electric bicycle or motorcycle collision. 

Coding tidbits  

• Deleted codes often become new parent codes. such as:  

Deleted: N80.0 Endometriosis of uterus (deleted) 
New parent code: N80.0 Endometriosis of uterus (new category)

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

While code N80.0 was “officially” deleted, it became a new parent code with the newly added codes providing greater specificity about endometriosis of the uterus.  

Whenever the code updates include a larger than average increase in new codes, it is often due to expansion of code categories that include the following details:  

• Laterality 
  • Codes addressing laterality often see an increase of four new codes to include right, left, bilateral and unspecified.  
• Multiple anatomic sites affected by the same condition 
  • As is the case for the newly added endometriosis codes, multiple anatomic sites were added, resulting in a significant increase of new codes. 
• When codes are added that include episodes of care 
  • Injuries are an example of this, where additional new codes would be added to ensure reporting to the highest specificity for the initial, subsequent or sequela episode of care. 
• Timeframes (e.g., coma scale)  
  • Some codes like coma scale that include a seventh character for highest specificity reporting, may result in the addition of up to five additional new codes each time a new code is added to this category (e.g., R40.1220) 
• Fractures 
  • New codes added to describe fractures also add up quickly when the type of fracture (e.g., compound, displaced), laterality and the episode of care are all considered as well. 
• Fetal identification 
  • Codes describing conditions affecting a fetus automatically have an option of reporting specificity, by identifying which fetus is affected with options for 1-6. 

Performing an annual review of the ICD-10-CM Official Coding Guidelines is a great habit to institute. Whenever new codes are added to the code set, the guidelines usually undergo updates as well. This is a great way to stay on top of vital changes and show your value as an employee or staff member who remains current on important topics.  

Mid-year code updates 

Over the past few years, we have seen changes to the code set and guidelines being published throughout the year and not just as part of the annual update. While this has always been part of the process, we have seen an increase in these types of updates due to the public health emergency (PHE) for COVID-19. It is a good reminder to keep up to date on any mid-year published changes and the effective dates and guidelines. With the latest PHE extension announced effective through January 11, 2023, it is possible we may continue to see COVID-19-related code and/or guideline updates between now and next October. 

Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT, coding analyst at 3M Health Information Systems.