October Coding Tip Corner

ICD-10-CM Changes Affecting Risk Adjustment
Fall is upon us, and as the seasons change, so do ICD-10-CM codes!

Effective October 1, there are 1,176 new billable codes, 251 codes deleted, several terms/inclusion terms modified, and 36 converted to parent codes. To put this in perspective, last year there were 159 new codes!

Below is a brief listing of the new ICD-10-CM changes affecting Risk Adjustment:

• Malignancies
• Hereditary Alpha Tryptasemia
• Hyperparathyroidism with hypercalcemia
• Depression, NOS (MAJOR CHANGE)
  • Major depressive disorder, single episode, unspecified
  • Depression, unspecified
• Acute flaccid myelitis
• Myelitis due to other causes
• Cardiovascular
• Bronchiectasis with infection
• Esophageal polyps
• Liver disease
• New stoma codes (These are irritant contact dermatitis related to various stomas that may be documented.) Please remember to code for the presence of the stoma or fistula with the new stoma codes found in the documentation.
• Cachexia (index-R codes)
• Microangiopathies
• Sjogren syndrome (formerly Sicca syndrome)
• Multisystem inflammatory syndrome (use additional post COVID-19 condition, U09.9)
• Ankylosing spondylitis
• Non-suicidal harm

The level of detailing also had some changes (effective October 1, 2022) as noted below.

Coding diagnosis codes are to be used and reported at the highest number of characters available and to the highest level of specificity documented in the medical record. ICD-10-CM diagnosis codes are composed of codes with 3, 4, 5, 6, or 7 characters. Codes with three characters are included in ICD-10-CM as the heading of a category of codes that may be further subdivided by using fourth, fifth, and/or sixth characters, which provide greater detail. A three-character code is to be used only if it is not further subdivided. A code is invalid if it has not been coded to the full number of characters required for that code, including the seventh character, if applicable.

There are three new codes that have been added for Social Determinants of Health:
Z59.82 Transportation Insecurity
Z59.86 Financial Insecurity
Z59.87 Material Hardship

• Includes: clothing, utilities, basic needs
• Excludes: Extreme poverty, financial insecurity not classified elsewhere, low income

Please be sure to update and capture the section of the medical record for these additional codes.