Pinnacle is conducting a four-part series to delve into the upcoming 2024 ICD-10 CM code changes and break them down chapter by chapter. On June 16, 2023, The Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2024 ICD-10-CM code set, which is set to take effect October 1, 2023. With 395 new code additions, 25 deletions, and 13 revisions, read on to learn more about changes within chapters 1-22.
Part One: Chapters 1-6
Chapter 1 – Certain infectious and parasitic diseases (A00-B99)
Two (2) new code additions to this chapter including several additions, deletions, and revisions to the Code First and Excludes 1 / 2 notes.
New codes:
- A41.54 Sepsis due to Acinetobacter baumannii
- B96.83 Acinetobacter baumannii causing diseases classified elsewhere
Acinetobacter baumannii is a bacterium that can spread through direct contact and can be found on skin and in food, water, or soil. It is not as common as other bacteria and can be resistant to nearly all antibiotics. The World Health Organization (WHO) has included Acinetobacter baumannii in the critical group of bacteria that are the greatest threat to human health.
Chapter 2 – Neoplasms (C00-D49)
Fourteen (14) code additions, most covering desmoid tumors in various locations on the body. Again, there were various additions, deletions, and revisions to the Code Also and Excludes 1 / 2 notes.
New codes:
- D13.91 Familial adenomatous polyposis
- D13.99 Benign neoplasm of ill-defined sites within the digestive system
- D48.11 – D48.119 Desmoid tumors
- D48.19 Other specified neoplasm of uncertain behavior of connective and other soft tissue
Familial adenomatous polyposis, called FAP or classic FAP, is a genetic condition. It is diagnosed when a person develops more than 100 adenomatous colon polyps. If FAP is not recognized and treated, there is a high likelihood that a person will develop colorectal cancer, as well as having an increased risk of developing cancer in other organs such as the stomach, small intestine, pancreas, and biliary tree.
Desmoid tumors, otherwise known as aggressive fibromatosis or desmoid-type fibromatosis, are noncancerous growths that occur in the connective tissue. A desmoid tumor can occur anywhere in the body but is often found in the abdomen, shoulders, upper arms, and thighs. Desmoid tumors can grow slowly or very quickly, be very painful, and hard to completely remove with surgery.
Chapter 3 – Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)
Eight (8) new codes in this chapter cover Sickle-cell conditions with dactylitis as well as numerous additions, deletions, and revisions to the code descriptions, Code Also, Code First, and Use Additional code rules.
Added codes:
- D57.04 Hb-SS disease with dactylitis
- D57.214 Sickle-cell / Hb-C disease with dactylitis
- D57.414 Sickle-cell thalassemia, unspecified, with dactylitis
- D57.434 Sickle-cell thalassemia beta zero with dactylitis
- D57.454 Sickle-cell thalassemia beta plus with dactylitis
- D57.814 Other sickle-cell disorders with dactylitis
- D61.02 Shwachman-Diamond Syndrome
- D89.84 IgG4-related disease
Dactylitis is an inflammation of a digit (either finger or toe). It is sometimes called “sausage fingers” because of the round, puffed up shape it gives your digits.
Chapter 4 – Endocrine, nutritional, and metabolic diseases (E00-E89)
We see considerable changes in this chapter including nineteen (19) new codes (many for hypoparathyroidism conditions). Also, several changes have been made to the Code First, Code Also, Excludes 1 / 2 rules, as well as some additions and deletions to code descriptions.
Added codes:
- E20.8 was expanded to include the following codes:
- E20.81 Other hypoparathyroidism
- E20.810 Autosomal dominant hypocalcemia
- E20.811 Secondary hypoparathyroidism in diseases classified elsewhere
- E20.812 Autoimmune hypoparathyroidism
- E20.818 Other hypoparathyroidism due to impaired PTH secretion
- E20.819 Hypoparathyroidism due to impaired PTH secretion, unspecified
- E20.89 Other specified hypoparathyroidism
- E74.05 Lysosome-associated membrane protein 2 [LAMP2] deficiency
- E75.27 Pelizaeus-Merzbacher Disease
- E75.28 Canavan disease
- E79.81 Aicardi-Goutieres Syndrome
- E79.82 Hereditary xanthinuria
- E79.89 Other disorders of purine and pyrimidine metabolism
- E88.43 Disorders of mitochondrial tRNA synthetases
- E88.81 was expanded to include:
- E88.810 Metabolic syndrome
- E88.811 Insulin resistance syndrome, Type A
- E88.818 Other insulin resistance
- E88.819 Insulin resistance, unspecified
- E88.A Wasting disease (syndrome) due to underlying condition
Hypoparathyroidism is a condition in which the body produces abnormally low levels of parathyroid hormone (PTH), which helps to regulate and maintain a balance of two minerals in the body — calcium and phosphorus. The low production of PTH in hypoparathyroidism leads to abnormally low calcium levels in the blood and an increase of phosphorus in the blood. Symptoms are different for each individual but some of the common ones are uncontrollable, painful spasms of your face, hands, arms, and feet and a burning or prickling feeling, like pins and needles in your hands, feet, and around your mouth.
Chapter 5 – Mental, Behavioral and Neurodevelopmental disorders (F01-F99)
There were no new codes for this chapter this year, however, there are a handful of changes to code descriptions and several changes to the Code First and Excludes 1 / 2 notes. One of most notable highlights of this chapter is the code descriptor adding “gender incongruence” to gender identity disorder.
Chapter 6 – Diseases of the nervous system (G00-G99)
Thirty-two (32) new codes were added to this chapter including:
- G11.5 Hypomyelination – hypogonadotropic hypogonadism – hypodontia
- G11.6 Leukodystrophy with vanishing white matter disease
- Parkinson’s disease with or without dyskinesia, with or without fluctuations
- G20A 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
- G20B 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
- G23.3 Hypomyelination with atrophy of the basal ganglia and cerebellum
- G31.80 Leukodystrophy, unspecified
- G31.86 Alexander disease
- G37.81 Myelin oligodendrocyte glycoprotein antibody disease
- G37.89 Other specified demyelinating diseases of central nervous system
- Lafora progressive epilepsy
- G40.C Lafora progressive myoclonus epilepsy
- G40.C0 Lafora progressive myoclonus epilepsy, not intractable
- G40.C01 Lafora progressive myoclonus epilepsy, not intractable, with status epilepticus
- G40.C09 Lafora progressive myoclonus epilepsy, not intractable, without status epilepticus
- G40.C1 Lafora progressive myoclonus epilepsy, intractable
- G40.C11 Lafora progressive myoclonus epilepsy, intractable, with status epilepticus
- G40.C19 Lafora progressive myoclonus epilepsy, intractable, without status epilepticus
- Chronic migraine with aura
- G43.E Chronic migraine with aura
- G43.E0 Chronic migraine with aura, not intractable
- G43.E01 Chronic migraine with aura, not intractable, with status migrainosus
- G43.E09 Chronic migraine with aura, not intractable, without status migrainosus
- G43.E1 Chronic migraine with aura, intractable
- G43.E11 Chronic migraine with aura, intractable, with status migrainosus
- G43.E19 Chronic migraine with aura, intractable, without status migrainosus
- G90.B LMNB1-related autosomal dominant leukodystrophy
- G93.42 Megalencephalic leukoencephalopathy with subcortical cysts
- G93.43 Leukoencephalopathy with calcifications and cysts
- G93.44 Adult-onset leukodystrophy with axonal spheroids
Aside from the added codes, look for additional changes to code descriptions, Code First, Code Also, Excludes 1 / 2, and Use Additional Code rules.
Lafora disease is a type of progressive myoclonic epilepsy that is inherited in an autosomal recessive gene. This condition typically presents with new onset of myoclonic, occipital, or generalized tonic-clonic seizures in otherwise previously healthy adolescents. Dementia, ataxia, and dysarthria progress rapidly and myoclonus worsens to the point where it is nearly constant and intractable epilepsy develops.
Part Two: Chapters 7-12
Chapter 7 – Diseases of the eye and adnexa (H00-H59)
Forty-seven (47) added codes to this chapter, many of them covering muscle entrapment. There is one (1) code revision to this chapter to look out for and there were also various additions, deletions, and revisions to the code descriptions, Code First, Code Also, Use Additional, and Excludes 2 Rules.
Added codes:
- H36.8 Other retinal disorders in disease classified elsewhere
- H36.81 Nonproliferative sickle-cell retinopathy
- H36.811 Nonproliferative sickle-cell retinopathy, right eye
- H36.812 Nonproliferative sickle-cell retinopathy, left eye
- H36.813 Nonproliferative sickle-cell retinopathy, bilateral
- H36.819 Nonproliferative sickle-cell retinopathy, unspecified eye
- H36.82 Proliferative sickle-cell retinopathy
- H36.821 Proliferative sickle-cell retinopathy, right eye
- H36.822 Proliferative sickle-cell retinopathy, left eye
- H36.823 Proliferative sickle-cell retinopathy, bilateral
- H36.829 Proliferative sickle-cell retinopathy, unspecified eye
- H36.89 Other retinal disorders in diseases classified elsewhere
- H50.62 Inferior oblique muscle entrapment
- H50.621 Inferior oblique muscle entrapment, right eye
- H50.622 Inferior oblique muscle entrapment, left eye
- H50.629 Inferior oblique muscle entrapment, unspecified eye
- H50.63 Inferior rectus muscle entrapment
- H50.631 Inferior rectus muscle entrapment, right eye
- H50.632 Inferior rectus muscle entrapment, left eye
- H50.639 Inferior rectus muscle entrapment, unspecified eye
- H50.64 Lateral rectus muscle entrapment
- H50.641 Lateral rectus muscle entrapment, right eye
- H50.642 Lateral rectus muscle entrapment, left eye
- H50.649 Lateral rectus muscle entrapment, unspecified eye
- H50.65 Medial rectus muscle entrapment
- H50.651 Medial rectus muscle entrapment, right eye
- H50.652 Medial rectus muscle entrapment, left eye
- H50.659 Medial rectus muscle entrapment, unspecified eye
- H50.66 Superior oblique muscle entrapment
- H50.661 Superior oblique muscle entrapment, right eye
- H50.662 Superior oblique muscle entrapment, left eye
- H50.669 Superior oblique muscle entrapment, unspecified eye
- H50.67 Superior rectus muscle entrapment
- H50.671 Superior rectus muscle entrapment, right eye
- H50.672 Superior rectus muscle entrapment, left eye
- H50.679 Superior rectus muscle entrapment, unspecified eye
- H50.68 Extraocular muscle entrapment, unspecified
- H50.681 Extraocular muscle entrapment, unspecified, right eye
- H50.682 Extraocular muscle entrapment, unspecified, left eye
- H50.689 Extraocular muscle entrapment, unspecified, unspecified eye
- H54.512 Low vision, right eye, category 2
- H54.512A Low vision right eye category 2, normal vision left eye
- H57.8A Foreign body sensation eye (ocular)
- H57.8A1 Foreign body sensation, right eye
- H57.8A2 Foreign body sensation, left eye
- H57.8A3 Foreign body sensation, bilateral eyes
- H57.8A9 Foreign body sensation, unspecified eye
Ocular muscle entrapment occurs when extraocular muscles or associated soft tissue become trapped in an orbital bone fracture. This can lead to bradycardia, permanent diplopia, or even death. Extraocular muscle entrapment requires urgent surgical correction which makes it essential to avoid delays in getting diagnosed.
Chapter 8 – Diseases of the ear and mastoid process (H60-H95)
No new codes were added to this chapter but watch for a couple of revisions to the Code First rules for H62.4 Otitis externa in other diseases classified elsewhere and H91.0 Ototoxic hearing loss.
Chapter 9 – Diseases of the circulatory system (I00-I99)
Eleven (11) new additions to this chapter along with several code revisions. You see changes to the hypertension code set as well as code description changes that redefine “abdominal” aortic aneurysm to “thoracoabdominal” aortic aneurysm. There are also various other additions, deletions, and revisions to code descriptions, Code First, Code Also, Use Additional, and Excludes 1 / 2 rules.
Added codes:
- I1A Other hypertension
- I1A.0 Resistant hypertension
- I20.81 Angina pectoris with coronary microvascular dysfunction
- I20.89 Other forms of angina pectoris
- I21.B Myocardial infarction with coronary microvascular dysfunction
- I24.81 Acute coronary microvascular dysfunction
- I24.89 Other forms of acute ischemic heart disease
- I25.85 Chronic coronary microvascular dysfunction
- I47.10 Supraventricular tachycardia, unspecified
- I47.11 Inappropriate sinus tachycardia, so stated
- I47.19 Other supraventricular tachycardia
Revised codes:
- I25.112 Atherosclerotic heart disease of native coronary artery with refractory angina pectoris
- I10-I1A Hypertensive diseases
- I71.51 Supraceliac aneurysm of the thoracoabdominal aorta, ruptured
- I71.52 Paravisceral aneurysm of the thoracoabdominal aorta, ruptured
- I71.61 Supraceliac aneurysm of the thoracoabdominal aorta, without rupture
- I71.62 Paravisceral aneurysm of the thoracoabdominal aorta, without rupture
A thoracoabdominal aortic aneurysm is a bulging in the aorta that extends from the chest to the abdomen and is considered more complex to treat due to the complexity of the location. These aneurysms are classified according to the Crawford Classification:
- Extent I: involves the majority of the descending thoracic aorta as well as the upper abdominal aorta.
- Extent II: involves most of the descending thoracic aorta and most of the abdominal aorta.
- Extent III: involves the lower descending thoracic aorta and most of the abdominal aorta.
- Extent IV: involves most or all of the abdominal aorta.
- Extent V: involves the lower descending thoracic aorta and the upper abdominal aorta.
Treatment options include open repair, thoracic endovascular aortic repair (TEVAR) plus open repair, or fenestrated endovascular aortic repair (FEVAR).
Chapter 10 – Diseases of the respiratory system (J00-J99)
Nine (9) new code additions to this chapter including a few additions for chronic lung allograft dysfunction and revisions to chronic lower respiratory disease to expand out the code set. There are various changes to code descriptions, Use Additional, Excludes 1 / Excludes 2, Code First, and Code Also Rules.
Added codes:
- J15.61 Pneumonia due to Acinetobacter baumannii
- J15.69 Pneumonia due to other Gram-negative bacteria
- J44.8 Other specified chronic obstructive pulmonary disease
- J44.81 Bronchiolitis obliterans and bronchiolitis obliterans syndrome
- J44.89 Other specified chronic obstructive pulmonary disease
- J4A Chronic lung allograft dysfunction
- J4A.0 Restrictive allograft syndrome
- J4A.8 Other chronic lung allograft dysfunction
- J4A.9 Chronic lung allograft dysfunction, unspecified
Chapter 11 – Diseases of the digestive system (K00-K95)
There are twenty (20) new codes to this section including new codes for intestinal microbial overgrowth. There are also various changes to code descriptions, Code First, Code Also, and Excludes 1 / 2 Rules.
Added codes:
- K35.20 Acute appendicitis with generalized peritonitis, without abscess
- K35.200 Acute appendicitis with generalized peritonitis, without perforation or abscess
- K35.201 Acute appendicitis with generalized peritonitis, with perforation, without abscess
- K35.209 Acute appendicitis with generalized peritonitis, without abscess, unspecified as to perforation
- K35.210 Acute appendicitis with generalized peritonitis, without perforation, with abscess
- K35.211 Acute appendicitis with generalized peritonitis, with perforation and abscess
- K35.219 Acute appendicitis with generalized peritonitis, with abscess, unspecified as to perforation
- K63.82 Intestinal microbial overgrowth
- K63.821 Small intestinal bacterial overgrowth
- K63.8211 Small intestinal bacterial overgrowth, hydrogen-subtype
- K63.8212 Small intestinal bacterial overgrowth, hydrogen sulfide-subtype
- K63.8219 Small intestinal bacterial overgrowth, unspecified
- K63.822 Small intestinal fungal overgrowth
- K63.829 Intestinal methanogen overgrowth, unspecified
- K68.2 Retroperitoneal fibrosis
- K68.3 Retroperitoneal hematoma
- K90.82 Short bowel syndrome
- K90.821 Short bowel syndrome with colon in continuity
- K90.822 Short bowel syndrome without colon in continuity
- K90.829 Short bowel syndrome, unspecified
- K90.83 Intestinal failure
Small intestinal bacterial overgrowth (SIBO) occurs when there is an abnormal increase in the overall bacterial population in the small intestine, types not commonly found in the small intestine. Usually this is caused by a slowing of food passage and waste products in the digestion tract because of abdominal surgery. This can cause diarrhea, weight loss, and malnutrition. Most of the time antibiotics will treat this condition but sometimes surgery is needed.
Chapter 12 – Diseases of the skin and subcutaneous tissue (L00-L99)
There weren’t any added codes to this chapter but watch out for a change to a Code First Rule for L53.0 Toxic erythema.
Part Three: Chapters 13-18
Chapter 13 – Diseases of the musculoskeletal system and connective tissue (M00-M99)
Forty-eight (48) codes added to this chapter to expand the definition of osteoporosis with current pathological fracture. Within these code changes, you will also need to remember the episode(s) of care (A, D, G, K, P, S) are included within the forty-eight-code count. There are also various code description changes, Excludes 1, Excludes 2, Use Additional, and Code First Rule changes.
Added Codes:
- M80.0B Age-related osteoporosis with current pathological fracture, pelvis
- M80.0B1 Age-related osteoporosis with current pathological fracture, right pelvis
- M80.0B2 Age-related osteoporosis with current pathological fracture, left pelvis
- M80.0B9 Age-related osteoporosis with current pathological fracture, unspecified pelvis
- M80.8B Other osteoporosis with current pathological fracture, pelvis
- M80.8B1 Other osteoporosis with current pathological fracture, right pelvis
- M80.8B2 Other osteoporosis with current pathological fracture, left pelvis
- M80.8B9 Other osteoporosis with current pathological fracture, unspecified pelvis
Chapter 14 – Diseases of the genitourinary system (N00-N99)
Sixteen (16) new codes for this chapter centered on types of nephropathies and glomerulonephritis. You will see various changes to code descriptions, Code First, Use Additional, Excludes 1, and Excludes 2 Rules as well.
Added Codes:
- N02.B Recurrent and persistent immunoglobulin A nephropathy
- N02.B1 Recurrent and persistent immunoglobulin A nephropathy with glomerular lesion
- N02.B2 Recurrent and persistent immunoglobulin A nephropathy with focal and segmental glomerular lesion
- N02.B3 Recurrent and persistent immunoglobulin A nephropathy with diffuse membranoproliferative glomerulonephritis
- N02.B4 Recurrent and persistent immunoglobulin A nephropathy with diffuse membranous glomerulonephritis
- N02.B5 Recurrent and persistent immunoglobulin A nephropathy with diffuse mesangial proliferative glomerulonephritis
- N02.B6 Recurrent and persistent immunoglobulin A nephropathy with diffuse mesangiocapillary glomerulonephritis
- N02.B9 Other recurrent and persistent immunoglobulin A nephropathy
- N04.20 Nephrotic syndrome with diffuse membranous glomerulonephritis, unspecified
- N04.21 Primary membranous nephropathy with nephrotic syndrome
- N04.22 Secondary membranous nephropathy with nephrotic syndrome
- N04.29 Other nephrotic syndrome with diffuse membranous glomerulonephritis
- N06.20 Isolated proteinuria with diffuse membranous glomerulonephritis, unspecified
- N06.21 Primary membranous nephropathy with isolated proteinuria
- N06.22 Secondary membranous nephropathy with isolated proteinuria
- N06.29 Other isolated proteinuria with diffuse membranous glomerulonephritis
Chapter 15 – Pregnancy, childbirth, and the puerperium (O00-O9A)
Seven (7) codes additions for this chapter and various changes to description changes, Includes, Code First, Use Additional, and Excludes 1 / 2 Rules
Added Codes:
- O26.64 Intrahepatic cholestasis of pregnancy
- O26.641 Intrahepatic cholestasis of pregnancy, first trimester
- O26.642 Intrahepatic cholestasis of pregnancy, second trimester
- O26.643 Intrahepatic cholestasis of pregnancy, third trimester
- O26.649 Intrahepatic cholestasis of pregnancy, unspecified trimester
- O90.41 Hepatorenal syndrome following labor and delivery
- O90.49 Other postpartum acute kidney failure
Chapter 16 – Certain conditions originating in the perinatal period (P00-P96)
No new codes for this chapter, however, there is one revised code and look out for changes to code descriptions, Code First, Code Also, Use Additional, Excludes 1 / 2 Rules.
Chapter 17 – Congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
There are twenty-six (26) new codes for this chapter, including new codes for Craniosynostosis. You will see multiple code revisions and there are also various changes to code descriptions, Code Also, Use Additional, and Excludes 1 / 2 Rules.
Added Codes:
- Q44.7 Other congenital malformations of liver
- Q44.70 Other congenital malformation of liver, unspecified
- Q44.71 Alagille syndrome
- Q44.79 Other congenital malformations of liver
- Q75.0 Craniosynostosis
- Q75.00 Craniosynostosis unspecified
- Q75.001 Craniosynostosis unspecified, unilateral
- Q75.002 Craniosynostosis unspecified, bilateral
- Q75.009 Craniosynostosis unspecified
- Q75.01 Sagittal craniosynostosis
- Q75.02 Coronal craniosynostosis
- Q75.021 Coronal craniosynostosis unilateral
- Q75.022 Coronal craniosynostosis bilateral
- Q75.029 Coronal craniosynostosis unspecified
- Q75.03 Metopic craniosynostosis
- Q75.04 Lambdoid craniosynostosis
- Q75.041 Lambdoid craniosynostosis, unilateral
- Q75.042 Lambdoid craniosynostosis, bilateral
- Q75.049 Lambdoid craniosynostosis, unspecified
- Q75.05 Multi-suture craniosynostosis
- Q75.051 Cloverleaf skull
- Q75.052 Pansynostosis
- Q75.058 Other multi-suture craniosynostosis
- Q75.08 Other single suture craniosynostosis
- Q87.8 Other specified congenital malformation syndromes, not elsewhere classified
- Q87.83 Bardet-Biedl syndrome
- Q87.84 Laurence-Moon syndrome
- Q87.85 MED13L syndrome
- Q93.52 Phelan-McDermid syndrome
Chapter 18 – Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
There are twenty-four (24) new codes for this chapter including new codes for abnormal and inconclusive findings on diagnostic imaging of breast. Also, look out for various additions or revisions to the code descriptions, Excludes 1 / 2, Code First, and Code Also Rules.
Added Codes:
- 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
- R40.2A Nontraumatic coma due to underlying condition
- R92.3 Mammographic density found on imaging of breast
- R92.30 Dense breasts, unspecified
- R92.31 Mammographic fatty tissue density of breast
- R92.311 Mammographic fatty tissue density, right breast
- R92.312 Mammographic fatty tissue density, left breast
- R92.313 Mammographic fatty tissue density, bilateral breasts
- R92.32 Mammographic fibroglandular density of breast
- R92.321 Mammographic fibroglandular density, right breast
- R92.322 Mammographic fibroglandular density, left breast
- R92.323 Mammographic fibroglandular density, bilateral breasts
- R92.33 Mammographic heterogeneous density of breast
- R92.331 Mammographic heterogeneous density, right breast
- R92.332 Mammographic heterogeneous density, left breast
- R92.333 Mammographic heterogeneous density, bilateral breasts
- R92.34 Mammographic extreme density of breast
- R92.341 Mammographic extreme density, right breast
- R92.342 Mammographic extreme density, left breast
- R92.343 Mammographic extreme density, bilateral breasts
Part Four: Chapters 19-22
Chapter 19 – Injury, poisoning and certain other consequences of external causes (S00-T88)
There are fifteen (15) new codes in this chapter for toxic effects of gadolinium. Within these code changes, you will also need to remember the episode(s) of care (A, D, or S) are included within the fifteen-code count. You’ll also see various changes to the Excludes 1 / 2, Code First, Code Also, and Use Additional Rules.
Added codes:
- T56.82 Toxic effect of gadolinium
- T56.821 Toxic effect of gadolinium, accidental (unintentional)
- T56.822 Toxic effect of gadolinium, intentional self-harm
- T56.823 Toxic effect of gadolinium, assault
- T56.824 Toxic effect of gadolinium, undetermined
Gadolinium is a contrast used in MRI scans which enhances the quality of the images. Toxicity can occur within hours after an MRI scan or years later in people who have a build-up of gadolinium in their system. Symptoms vary and include nausea, vomiting, diarrhea, brain fog, burning or pins and needles sensation in the skin, and changes to the skin such as thickening or discoloration.
Chapter 20 – External causes of morbidity (V00-Y99)
One hundred seventy-three (173) new codes in this chapter centered on foreign bodies entering into or through a natural orifice. The episode of care (A, D, or S) will need to be added to codes in the W44 category and are included in the code count. You’ll also see changes to the Excludes 1 / 2 Rules.
Added codes:
- W44 Foreign body entering into or through a natural orifice
- W448 Other foreign body entering into or through a natural orifice
- W449 Unspecified foreign body entering into or through a natural orifice
- W44A Battery entering into or through a natural orifice
- W44A0 Battery unspecified, entering into or through a natural orifice
- W44A1 Button battery entering into or through a natural orifice
- W44A9 Other batteries entering into or through a natural orifice
- W44A9XA Other batteries entering into or through a natural orifice, initial encounter
- W44B Plastic entering into or through a natural orifice
- W44B0 Plastic object unspecified, entering into or through a natural orifice
- W44B1 Plastic bead entering into or through a natural orifice
- W44B2 Plastic coin entering into or through a natural orifice
- W44B3 Plastic toy and toy part entering into or through a natural orifice
- W44B4 Plastic jewelry entering into or through a natural orifice
- W44B5 Plastic bottle entering into or through a natural orifice
- W44B9 Other plastic object entering into or through a natural orifice
- W44C Glass entering into or through a natural orifice
- W44C0 Glass unspecified, entering into or through a natural orifice
- W44C1 Sharp glass entering into or through a natural orifice
- W44C2 Intact glass entering into or through a natural orifice
- W44D Magnetic metal entering into or through a natural orifice
- W44D0 Magnetic metal object unspecified, entering into or through a natural orifice
- W44D1 Magnetic metal bead entering into or through a natural orifice
- W44D2 Magnetic metal coin entering into or through a natural orifice
- W44D3 Magnetic metal toy entering into or through a natural orifice
- W44D4 Magnetic metal jewelry entering into or through a natural orifice
- W44D9 Other magnetic metal objects entering into or through a natural orifice
- W44E Non-magnetic metal entering into or through a natural orifice
- W44E0 Non-magnetic metal object unspecified, entering into or through a natural orifice
- W44E1 Non-magnetic metal bead entering into or through a natural orifice
- W44E2 Non-magnetic metal coin entering into or through a natural orifice
- W44E3 Non-magnetic metal toy entering into or through a natural orifice
- W44E4 Non-magnetic metal jewelry entering into or through a natural orifice
- W44E9 Other non-magnetic metal objects entering into or through a natural orifice
- W44F Objects of natural or organic material entering into or through a natural orifice
- W44F0 Objects of natural or organic material unspecified, entering into or through a natural orifice
- W44F1 Bezoar entering into or through a natural orifice
- W44F2 Rubber band entering into or through a natural orifice
- W44F3 Food entering into or through a natural orifice
- W44F4 Insect entering into or through a natural orifice
- W44F9 Other object of natural or organic material, entering into or through a natural orifice
- W44G Other non-organic objects entering into or through a natural orifice
- W44G0 Other non-organic objects unspecified, entering into or through a natural orifice
- W44G1 Audio device entering into or through a natural orifice
- W44G2 Combination metal and plastic toy and toy part entering into or through natural orifice
- W44G3 Combination metal and plastic jewelry entering into or through a natural orifice
- W44G9 Other non-organic objects entering into or through a natural orifice
- W44H Other sharp object entering into or through a natural orifice
- W44H0 Other sharp object unspecified, entering into or through a natural orifice
- W44H1 Needle entering into or through a natural orifice
- W44H2 Knife, sword or dagger entering into or through a natural orifice
Chapter 21 – Factors influencing health status and contact with health services (Z00-Z99)
There are thirty-three (33) new codes in this chapter including some new codes for family history of colon polyps and caregiver’s non-compliance with types of medical treatment. Look for various changes to code descriptions, the Excludes 1 / 2, and Code Also Rules as well.
Added codes:
- Z02.84 Encounter for child welfare exam
- Z05.81 Observation and evaluation of newborn for suspected condition related to home physiologic monitoring device ruled out
- Z05.89 Observation and evaluation of newborn for other specified suspected condition ruled out
- Z16.13 Resistance to carbapenem
- Z22.34 Carrier of Acinetobacter baumannii
- Z22.340 Carrier of carbapenem-resistant Acinetobacter baumannii
- Z22.341 Carrier of carbapenem-sensitive Acinetobacter baumannii
- Z22.349 Carrier of Acinetobacter baumannii, unspecified
- Z22.35 Carrier of Enterobacterales
- Z22.350 Carrier of carbapenem-resistant Enterobacterales
- Z22.358 Carrier of other Enterobacterales
- Z22.359 Carrier of Enterobacterales, unspecified
- Z29.81 Encounter for HIV pre-exposure prophylaxis
- Z29.89 Encounter for other specified prophylactic measures
- Z62.23 Child in custody of non-parental relative
- Z62.24 Child in custody of non-relative guardian
- Z62.823 Parent-step child conflict
- Z62.83 Non-parental relative or guardian-child conflict
- Z62.831 Non-parental relative-child conflict
- Z62.832 Non-relative guardian-child conflict
- Z62.833 Group home staff-child conflict
- Z62.892 Runaway [from current living environment]
- Z83.710 Family history of adenomatous and serrated polyps
- Z83.711 Family history of hyperplastic colon polyps
- Z83.718 Other family history of colon polyps
- Z83.719 Family history of colon polyps, unspecified
- Z91.A41 Caregiver’s other noncompliance with patient’s medication regimen due to financial hardship
- Z91.A48 Caregiver’s other noncompliance with patient’s medication regimen for other reason
- Z91.A51 Caregiver’s noncompliance with patient’s renal dialysis due to financial hardship
- Z91.A58 Caregiver’s noncompliance with patient’s renal dialysis for other reason
- Z91.A91 Caregiver’s noncompliance with patient’s other medical treatment and regimen due to financial hardship
- Z91.A98 Caregiver’s noncompliance with patient’s other medical treatment and regimen for other reason
- Z91.85 Personal history of military service
Chapter 22 – Codes for special purposes (U00-U85)
There were no new codes added to this chapter but watch for the Use Additional and Excludes 2 Rule changes for U07.1 COVID-19.
For more information about the upcoming 2024 ICD-10 changes, contact Pinnacle Enterprise Risk Consulting Services Manager of Professional Coding and Compliance Reviews, CPC, CPMA, Robin Peterson, at RPeterson@AskPHC.com or Manager HCC Coding/Audit & Education Services, CCS, CRC, CPA-RA, CPC, CPMA, CPCO, CDEI, CDEO, CDEC, CANPC, CASCC, CMPM, AHIMA Certified Risk Adjustment Auditor, AAPC Approved Instructor, Approved ICD-10-CM/PCS Trainer, Amy Pritchett, at APritchett@AskPHC.com.
