Since we are soon going to enter the October month, their are new ICD-10 Updates for next year 2024 and will be effective from 1st October 2024.
Every year on April 1 and October 1, ICD-10-CM coding changes take effect. For fiscal year (FY) 2024, the October update will bring:
- 395 new diagnosis codes
- 25 deletions of existing codes
- 22 code revisions
- 131 new headers
- Four revised headers
Their are other updates as well which include changes to code first instructions, Excludes1 and Excludes2 notes, laterality, and use additional code directions. Almost every chapter will have an update, so reviewing the chapter notes and section notes is highly recommended.
Here is a general overview of some of the updates coders can expect to see by chapter:
- Chapter 3: 21 new codes will be added
- Chapter 6: 24 new codes will be added
- Chapter 7: 34 new codes will be added
- Chapter 13: 36 new codes will be added
- Chapter 17: 22 new codes will be added
- Chapter 18: 18 new codes will be added
- Chapter 20: 123 new codes will be added
- Chapter 21: 30 new codes will be added
Chapter 1 – Infections and Parasitic Diseases
Sepsis due to a postprocedural infection
New guideline : For sepsis following a postprocedural wound (surgical site) infection, a code from T81.41 to T81.43, Infection following a procedure, or a code from O86.00 to O86.03, Infection of obstetric surgical wound, that identifies the site of the infection should be sequenced first, if known.
(old guideline: For infections following a procedure, a code from T81.40, to T81.43 Infection following a procedure, or a code from O86.00 to O86.03, Infection of obstetric surgical wound, that identifies the site of the infection should be coded first, if known.)
Screening for COVID-19
New guideline : For screening for COVID-19, including preoperative testing, assign code Z11.52, Encounter for screening for COVID-19.
[Old guideline: During the COVID-19 pandemic, a screening code is generally not appropriate. Do not assign code Z11.52, Encounter for screening for COVID-19. For encounters for COVID-19 testing, including preoperative testing, code as exposure to COVID-19 (guideline I.C.1.g.1.e).]
Chapter 3: Diseases of Blood and Blood-forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89)
Current code D48.1 (neoplasm of uncertain behavior of connective and other soft tissue) will be deleted. In its place will be the expanded subcategory D48.11- (desmoid tumors) of specified locations and D48.19 (other specified neoplasm of uncertain behavior).
Subcategory D57.2- (sickle-cell/Hb-C disease) will receive new additions. This chapter will also receive codes D61.02 (Schwachman-Diamond syndrome) and D89.84 (IgG4-related disease).
Chapter 6: Diseases of the Nervous System (G00-G99)
Present code G20 (Parkinson’s disease) will be deleted and turned into category G20.- (Parkinson’s disease). This new category will be expanded to include subcategories:
- G20.A-, Parkinson’s disease without dyskinesia
- G20.B-, Parkinson’s disease with dyskinesia
- G20.C-, Parkinsonism, unspecified
These new code subcategories will include options to report with and without dyskinesia, with and without fluctuations, or unspecified.
Other new code subcategories in this chapter will include:
- G40.C-, Lafora progressive myoclonus epilepsy
- G43.E-, chronic migraines with aura
The following codes will be added to capture more specific leukoencephalopathy:
- G93.42, megaloencephalic leukoencephalopathy with subcortical cysts
- G93.43, leukoencephalopathy with calcifications and cysts
- G93.44, adult-onset leukodystrophy with axonal spheroids
Chapter 7: Diseases of the Eye and Adnexa (H00-H59)
Several code subcategories and codes will be added for retinal disorders:
- H36.81-, nonproliferative sickle-cell retinopathy
- H36.82-, proliferative sickle-cell retinopathy
- H36.89, other retinal disorders in diseases classified elsewhere
Code subcategory H50.6- (mechanical strabismus) will include the largest addition of codes for diseases of the eye and adnexa. The codes within its category will cover the specific types of muscle entrapment: inferior oblique, inferior rectus, lateral rectus, medial rectus, superior oblique, superior rectus, and extraocular. These codes will also capture laterality.
Code subcategory H57.8A- (foreign body sensation eye [ocular]) will be added for foreign body sensation.
Chapter 9 – Diseases of Circulatory System
New guideline : 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.
Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
New codes in subcategory M80.0B- (age-related osteoporosis with current pathological fracture, pelvis) will be added. The codes require specificity of laterality, type of encounter, and condition of the fracture, such as malunion, nonunion, delayed healing, or routine healing.
Subcategory M80.8B- (other osteoporosis with current pathological fracture, pelvis) will be added, as well. Its codes will also require specificity similar to the codes in subcategory M80.0B-.
Chapter 17: Congenital Malformations, Deformations, and Chromosomal Abnormalities (Q00-Q99)
Current code Q75.0 (craniosynostosis) will be expanded to become subcategory Q75.0- (craniosynostosis), which will include the following subcategories and codes:
- Q75.01, sagittal craniosynostosis
- Q75.02-, coronal craniosynostosis
- Q75.03, metopic craniosynostosis
- Q75.04-, Lambdoid craniosynostosis
- Q75.05-, multi-suture craniosynostosis
- Q75.08, other single-suture craniosynostosis
Three additional codes, Q87.83 (Bardet-Biedl syndrome), Q87.84 (Laurence-Moon syndrome), and Q87.85 (MED13L syndrome), will be added to this chapter, as well.
Chapter 18: Symptoms, Signs, and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99)
Similar to the addition of the foreign body sensation codes for the diseases of the eye and adnexa, subcategory R09.A- (foreign body sensation of the circulatory and respiratory system) will be added to Chapter 18. The new codes in its subcategory will include specified locations of the foreign body sensation, such as the nose, throat, other site, or unspecified.
Another new subcategory will be R92.3- (mammographic density found on imaging of breast), which will capture specific types of mammographic breast density: dense, fatty tissue, fibroglandular, heterogenous, and extreme. Laterality will also be included in the new codes.
New guideline: 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.
[Old guideline: Code R40.20, Unspecified coma, may be assigned in conjunction with codes for any medical condition.]
The 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).
Chapter 20: External Cause of Morbidity (V00-Y99)
This chapter will receive the largest addition of new codes. A total of 123 new codes will be added to category W44.- (foreign body entering into or through natural orifice). The fourth character of each code in category W44.- will capture the specific type of foreign body material.
For instance, the following code subcategories exhibit the various objects for a coder to choose from, according to documentation:
- W44.A-, battery entering into or through a natural orifice
- W44.B-, plastic entering into or through a natural orifice
- W44.C-, glass entering into or through a natural orifice
- W44.D-, magnetic metal entering into or through a natural orifice
- W44.E-, non-magnetic metal entering into or through a natural orifice
- W44.F-, objects of natural or organic material entering into or through a natural orifice
- W44.G-, other non-organic objects entering into or through a natural orifice
- W44.H-, other sharp object entering into or through a natural orifice
- W44.8-, other foreign body entering into or through a natural orifice
- W44.9-, unspecified foreign body entering into or through a natural orifice
Chapter 21: Factors Influencing Health Status and Contact with Health Services (Z00-Z99)
New codes will be added to capture carriers of other specified infectious diseases, as seen in example subcategory Z22.34- (carrier of Acinetobacter baumannii) and Z22.35- (carrier of Enterobacterales).
New social determinants of health codes and subcategories will also be added:
- Z62.23, child in custody of non-parental relative
- Z62.24, child in custody of non-parental or non-relative guardian
- Z62.83-, non-parental, non-relative guardian, or group home staff child conflict
Current code Z83.71 (family history of colonic polyps) will be expanded into its own subcategory Z83.71-(family history of colonic polyps) to capture family history of more specific colonic polyps, such as adenomatous or hyperplastic polyps.
The following subcategories will be added to capture the caregiver’s noncompliance with certain aspects of patient care:
- Z91.A4-, caregiver’s other noncompliance with patient’s medication regimen
- Z91.A5-, caregiver’s noncompliance with patient’s renal dialysis
- Z91.A9-, caregiver’s noncompliance with patient’s other medical treatment and regimen
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)
