ICD-10-CM Updated Guidelines for April 2023 March 29, 2023

You may have heard about ICD-10 2023 coding guidelines and why they are essential. According to the Centers for Medicare & Medicaid Services (CMS) coding guidelines, by 2023, there will be over 68,000 ICD-10 codes. As a result, coding becomes more complex, and healthcare practices must stay up-to-date on the 2023 coding changes. 

Why is ICD important in healthcare?

There are several reasons why ICD-10-CM guidelines 2023 are important for healthcare practices. 

• The 2023 coding guidelines help providers code diagnoses and procedures accurately and consistently. Therefore, data reporting to health insurers and other organizations are more accurate. 

• The 2023 coding guidelines ensure consistency in sharing healthcare data across healthcare organizations.

• The 2023 coding changes allow healthcare providers to maximize reimbursement and reduce overpayments and underpayments. This coding guideline is especially critical considering that medical billing errors cost up to $2 billion.

Overall, the ICD-10-CM 2023 coding guidelines are important for healthcare practices because they aid in data reporting accuracy, facilitate patient data sharing, and reduce errors while optimizing reimbursement.

ICD-10-CM Updated Guidelines for April 2023 – New Codes and Highlights

ICD-10-CM 2023 Codes for Dementia 

The latest coding guidelines 2023 for dementia reporting emphasize the importance of thorough and accurate documentation from the provider. When a patient is admitted to an acute care hospital or another inpatient facility setting with dementia at one severity level, but the severity level increases, assign one code for the highest severity level reported during the stay.

The table below has the newly updated codes that help identify dementia with behavioral disturbances associated with Mental, Behavioral, and Neurodevelopmental Disorders (Chapter-5)

ICD-10-CM 2023 Codes for Injuries to the Head 

A total of 86 new codes related to head injuries are available, including new codes for concussions. Here are three examples of codes for concussions:

• S06.0XAA – Concussion with loss of consciousness status unknown, initial encounter
• S06.0XAD – Concussion with loss of consciousness status unknown, subsequent encounter
• S06.0XAS – Concussion with loss of consciousness status unknown, sequela

If the patient lost consciousness, the documentation should specify the concussion code.

ICD-10- CM 2023 Codes for Pain

The 2023 edition of ICD-10-CM R52 became effective on October 1, 2022. The list below shows the codes:

• Acute and chronic pain, not elsewhere classified (G89.-)
• Localized pain, unspecified type – code to pain by site, such as:
• Abdomen pain (R10.-)
• Back pain (M54.9)
• Breast pain (N64.4)
• Chest pain (R07.1-R07.9)
• Ear pain (H92.0-)
• Eye pain (H57.1)
• Headache (R51.9)
• Joint pain (M25.5-)
• Limb pain (M79.6-)
• Lumbar region pain (M54.5-)
• Pelvic and perineal pain (R10.2)
• Shoulder pain (M25.51-)
• Spine pain (M54.-)
• Throat pain (R07.0)
• Tongue pain (K14.6)
• Tooth pain (K08.8)
• Renal colic (N23)
• Pain disorders exclusively related to psychological factors (F45.41)

Meanwhile, the history of falling ICD-10 code is Z91. 81. It falls under the WHO category of Factors influencing health status and contact with healthcare services.

ICD-10-CM 2023 Codes for Maternal Care

Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A) include 200 new codes this year. The goal is to capture a large number of fetal disorders that need to be adequately captured in previous editions of the ICD-10-CM.

Below you will find some updates under the category of pregnancy and maternal care:

• O35.00 – Maternal care for (suspected) central nervous system malformation or damage in fetus, unspecified
• O35.01 – Maternal care for (suspected) central nervous system malformation or damage in fetus, agenesis of the corpus callosum
• O35.02 – Maternal care for (suspected) central nervous system malformation or damage in fetus, anencephaly
• O35.03 – Maternal care for (suspected) central nervous system malformation or damage in fetus, choroid plexus cysts
• O35.04 – Maternal care for (suspected) central nervous system malformation or damage in fetus, encephalocele
• O35.05 – Maternal care for (suspected) central nervous system malformation or damage in fetus, holoprosencephaly
• O35.06 – Maternal care for (suspected) central nervous system malformation or damage in fetus, hydrocephaly
• O35.07 – Maternal care for (suspected) central nervous system malformation or damage in fetus, microcephaly
• O35.08 – Maternal care for (suspected) central nervous system malformation or damage in fetus, spina bifida
• O35.09 – Maternal care for (suspected) other central nervous system malformation or damage in fetus
• O35.10 – Maternal care for (suspected) chromosomal abnormality in fetus, unspecified
• O35.11 – Maternal care for (suspected) chromosomal abnormality in fetus, Trisomy 13
• O35.12 – Maternal care for (suspected) chromosomal abnormality in fetus, Trisomy 18
• O35.13 – Maternal care for (suspected) chromosomal abnormality in fetus, Trisomy 21
• O35.14 – Maternal care for (suspected) chromosomal abnormality in fetus, Turner Syndrome
• O35.15 – Maternal care for (suspected) chromosomal abnormality in fetus, sex chromosome abnormality
• O35.19 – Maternal care for (suspected) chromosomal abnormality in fetus, other chromosomal abnormality
• O35.A – Maternal care for other (suspected) fetal abnormality and damage, fetal facial anomalies
• O35.B – “Maternal care for other (suspected) fetal abnormality and damage, fetal cardiac anomalies “
• O35.C – Maternal care for other (suspected) fetal abnormality and damage, fetal pulmonary
• O35.D – Maternal care for other (suspected) fetal abnormality and damage, fetal pulmonary anomalies, other fetus
• O35.E – Maternal care for other (suspected) fetal abnormality and damage, fetal gastrointestinal anomalies, other fetus
• O35.F – Maternal care for other (suspected) fetal abnormality and damage, fetal musculoskeletal anomalies of trunk
• O35.G – Maternal care for other (suspected) fetal abnormality and damage, fetal upper extremities anomalies
• O35.H – Maternal care for other (suspected) fetal abnormality and damage, fetal lower extremities anomalies

ICD-10-CM 2023 Codes for Endometriosis

Chapters 14 and 15 also contain several code updates. Moreover, the Diseases of Genitourinary System (Chapter 14) introduced 168 new codes to provide more specificity to the limiting legacy codes by adding anatomical positions, laterality, and depth.  

Below are some of the chapter 14 new codes:

• N80.00 – Endometriosis of the uterus, undefined
• N80.02 – Uterine deep endometriosis
• N80.10 – Ovarian endometriosis of unknown depth
• N80.129 – Deep ovarian endometriosis, unidentified ovary

New Codes for Methamphetamine Overdose

Methamphetamine produces euphoria and stimulating effects and is highly addictive. An overdose of Meth can result in dangerous symptoms such as:

• Agitation
• Stomach pains
• Seizures
• Chest pain
• Stroke
• Kidney damage
• Paranoia
• Heart failure
• Difficulty breathing

Methamphetamine poisoning, as well as meth-related adverse effects, will have a new ICD-10-CM 2023 code. The new code added to Chapter 19 is:

Code T43.65 Poisoning by the adverse effect of and underdosing of methamphetamines

Important Note: Chapter 19 Injury, Poisoning, Consequences of External Cause new guideline states that coders can assign an underdosing code even if the patient’s condition doesn’t change. According to the new guidelines, “Documentation that the patient is taking less of a medication than is prescribed or discontinued the prescribed medication is sufficient for code assignment.”

Other Changes in ICD-10-CM 2023 Coding Guidelines

There are fifteen new codes in category Z79 (long-term drug therapy). An updated guideline is available in Chapter 4 (Endocrine, Nutritional, and Metabolic Diseases):

• If a patient is both taking insulin and an injectable non-insulin antidiabetic drug, enter the codes Z79.4 (long-term [current] insulin use) and Z79.85 (long-term [current] injectable non-insulin antidiabetic drugs).

• If a patient is taking both oral hypoglycemics and an injectable non-insulin antidiabetic, use codes Z79.84 (long-term [current] use of oral hypoglycemic drugs) and Z79.85.

Tap Into Our Expertise

Aside from these changes, several new 2023 ICD-10-CM codes affect every specialty. Physicians looking to bill Medicare, Medicaid, and commercial payers will need to rely on the assistance of medical billing and coding service providers.

Worry no more! At 5 Star Billing Services Inc, we offer the highest level of performance for high-quality medical billing and coding. Save your money by outsourcing to a professional billing service.

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