Decoding 2024 ICD-10 CM Changes: A Four-Part Series

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.