The Centers for Disease Control and Prevention (CDC) published the ICD-10-CM Official Coding and Reporting Guidelines for the 2022 fiscal year (FY) on July 12. There are 115 pages in the new release, a decrease of 11 pages from the FY 2021 version. These guidelines become effective with Oct. 1, 2021 discharges/visits.
Narrative changes appear in bold text; underlined items have been moved within the guidelines since the FY 2021 version; italics are used to indicate revisions to headings.
Here are some of the changes for Section I (Conventions, General Coding Guidelines, and Chapter-Specific Guidelines) for sections A (Conventions) and B (General Coding Guidelines). The title for Chapter 21, subsection B-Z codes, Indicate a Reason for Encounter, has been added to include “or Provide Additional Information about a Patient Encounter.” For Section B (General Coding Guidelines), No. 2 (Level of Detail in Coding) has expanded the sentence of “diagnosis codes are to be used and reported at their highest number of characters available” to include “and to the highest level of specificity documented in the medical record.” No. 13 (Laterality) has added a paragraph regarding the specificity of laterality, stating that unspecified codes should rarely be used. The provider should be queried when conflicting or unclear documentation is present. No. 14 (Documentation by Other than the Patient’s Provider) has added a definition of “clinician,” as well as a list of exceptions where healthcare professionals may be used. There have been additional updates indicating that body mass index (BMI), coma scale, NIHSS, blood alcohol level, and codes for social determinants of health (SDoH) should only be reported as secondary codes. No. 18 (Use of Sign/Symptom/Unspecified Codes) has a new paragraph to emphasize the important of consistent, complete documentation in the medical record.
That is a glimpse into the changes in the Official Coding and Reporting Guidelines for ICD-10-CM FY 2022. These changes will be reviewed in further depth, along with the chapter-specific changes, during the 2022 Inpatient Prospective Payment System (IPPS) Summit: Master ICD-10-CM Changes on Aug. 17.
The Talk Ten Tuesdays Listeners Survey on July 13 asked, “which Official Coding and Reporting Guidelines are more impactful to you?” This revealed the following results:
Based on the results of this survey, the changes in the ICD-10-CM guidelines are very important to the audience. Remember that the guidelines and code changes will be further explained in an upcoming issue of the American Hospital Association’s (AHA’s) Coding Clinic.
Please note that a new version of the FY 2022 Conversion file for ICD-10-CM was released on June 30. This file helps the user translate from previous code versions to the current version, or in reverse as well.
Programming Note:
Listen to live reporting by Laurie Johnson during Talk Ten Tuesdays at 10 Eastern.
EDITOR’S NOTE: In recognition of National Doctors’ Day, coming up at the end of the month, starting Monday, March 25, MedLearn Media will be honoring
Skyrocketing rates of improper payments have coincided with historically rapid enrollment in the MA program. It was a Centers for Medicare & Medicaid Services (CMS)
Please log in to your account to comment on this article.
Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.
As AI reshapes healthcare compliance, the risk of biased outputs and opaque decision-making grows. This webcast, led by Frank Cohen, delivers a practical Four-Pillar Governance Framework—Transparency, Accountability, Fairness, and Explainability—to help you govern AI-driven claim auditing with confidence. Learn how to identify and mitigate bias, implement robust human oversight, and document defensible AI review processes that regulators and auditors will accept. Discover concrete remedies, from rotation protocols to uncertainty scoring, and actionable steps to evaluate vendors before contracts are signed. In a regulatory landscape that moves faster than ever, gain the tools to stay compliant, defend your processes, and reduce liability while maintaining operational effectiveness.
Get clear, practical answers to Medicare’s most confusing regulations. Join Dr. Ronald Hirsch as he breaks down real-world compliance challenges and shares guidance your team can apply right away.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more
Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
