ICD-10 coding changes kick in Oct. 1: 8 key things to know

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The fiscal year 2022 ICD-10-CM diagnosis code updates will become effective Oct. 1.

Here are eight key things to know:

1. The number of new codes. Compared to fiscal 2021, when 485 codes were added, just 165 codes were added in fiscal 2022.

2. Codes to further describe homelessness. The fiscal 2022 codeset has been expanded to specify homelessness as unspecified, sheltered or unsheltered.

3. Codes for COVID-19. This year, several codes were added to help providers indicate COVID-19-related conditions, treatment and testing. In particular, the codeset includes: U09.9, post COVID-19 condition, unspecified; J12.82; pneumonia due to coronavirus disease 2019; M35.81, multisystem inflammatory syndrome; M35.89, other specified system involvement of connective tissue; Z11.52, encounter for screening for COVID-19; Z20.822, contact with and (suspected) exposure to COVID-19; and Z86.16, personal history of COVID-19.

4. Expansion of codes for describing a cough. One of the biggest code changes in codes for symptoms, signs and abnormal clinical laboratory findings is the expansion of codes to describe a cough. There are now codes for acute cough, subacute cough, chronic cough, cough syncope, other specified cough and unspecified cough.

5. Codes for injuries, poisonings and certain other consequences of external causes. With 45 new codes, injuries, poisonings and consequences of external causes saw the greatest expansions of codes this year. Thirty-nine codes were added to describe adverse effects, underdosing and poisonings related to cannabis and synthetic cannabinoids, according to the Journal of American Health Information Management Association.

6. Codes for musculoskeletal system and connective tissue diseases in Chapter 13. There were 25 new codes added for the musculoskeletal system and connective tissue diseases. Nine codes cover non-radiographic axial spondyloarthritis by site.

7. Guidance changes for laterality. The guidance was updated to reflect that documentation from other clinicians may be used for laterality if it is not documented by the patient's provider. The guidance emphasizes that the codes for "unspecified" should rarely be used and in the event of "conflicting medical record documentation regarding the affected side, the patient's attending provider should be queried for clarification." 

8. Guidance change for codes relating to factors influencing health status and contact with health services. "The reason for the encounter (for example, screening or counseling) should be sequenced first and the appropriate personal and/or family history code(s) should be assigned as additional diagnos(es)," the new guidance states. 

Access the full guidance document from CMS here

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