The package includes three ICD-10-CM and seven procedure codes.
The Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS) have both stated that in April 2022, we will have three new ICD-10-CM codes and seven new procedure codes for COVID-19 therapeutics and vaccines.
You may recall that in the Inpatient Prospective Payment System (IPPS) Final Rule for the 2022 fiscal year (FY), it was stated that we would be moving to a twice-annual coding update, with the larger update being in October each year. With the continuing impact of the Public Health Emergency (PHE) and COVID-19 pandemic, we will see new codes initiated on April 1, 2022.
For ICD-10-CM, the following new codes should be utilized starting on that date:
ICD-10-CM Code Description
Z28.310 Unvaccinated for COVID-19
Z28.311 Partially vaccinated for COVID-19
Z28.39 Other underimmunization status
These three codes will be designated as “Non-CC” codes for IPPS, and would fall under MS-DRG 951, according to the grouper logic. A best practice is to educate your coding staff on these new codes and discuss the implications. Also, have an open dialogue about the situations when these codes would be assigned/used.
For ICD-10-PCS, the following new codes should be utilized starting on April 1, 2022:
PCS Code Description
XW013V7 Introduction of COVID-19 vaccine dose 3 into subcutaneous tissue, percutaneous approach, new technology group 7
XW013W7 Introduction of COVID-19 vaccine booster into subcutaneous tissue, percutaneous approach, new technology group 7
XW023V7 Introduction of COVID-19 vaccine does 3 into muscle, percut7R&aneous approach, new technology group 7
XW023W7 Introduction of COVID-19 vaccine booster into muscle, percutaneous approach, new technology group 7
XW0DXR7 Introduction of fostamatinib into mouth and pharynx, external approach, new technology group 7
XW0G7R7 Introduction of fostamatinib into upper GI, via natural or artificial opening, new technology group 7
XW0H7R7 Introduction of fostamatinib into lower GI, via natural or artificial opening, new technology group 7
CMS made this comment regarding the use of ICD-10-PCS vaccine codes:
“CMS notes that for hospitalized patients, Medicare pays for the COVID-19 vaccines and their administration separately from the Diagnosis-Related Group rate. As such, Medicare expects
that the appropriate CPT codes will be used when a Medicare beneficiary is administered a vaccine while a hospital inpatient. For details on billing Medicare for the COVID-19 vaccine
appropriately, please see this page in our provider toolkit:
https://www.cms.gov/medicare/covid-19/medicare-billing-covid-19-vaccine-shot-administration.”
Be sure that your facility or practice chargemaster is updated, if appropriate (for the CPT® codes). In addition, ensure that your coding staff is aware of these new ICD-10-CM/PCS codes as well. Note that these new PCS codes are “Non-OR” codes for the IPPS, and thus will not impact the MS-DRG.
Two additional steps to take include the following:
On the CMS web page on MS-DRG classifications and software, you can access the link to the file: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software
We are in very fluid times, so keeping up to date with code changes is essential.
In a recent article, I described a documentation environment governed by two distinct and often competing controlling systems. The first is the regulatory framework established
Risk adjustment has entered a new era. We are no longer operating in a documentation optimization environment; we are operating in an enforcement and recalibration
Please log in to your account to comment on this article.
Breast biopsy procedures may be clinically straightforward but accurately translating them into compliant billing can be anything but. In this focused webcast, Shawn Blackburn, CPC, CPMA, CIC, CRC, CCS-P breaks down how imaging guidance, lesion count, laterality, and payer expectations all impact how these procedures should be reported. Through clear explanations and real-world scenarios, you’ll gain practical insight into aligning clinical workflows with billing requirements, avoiding common pitfalls, and ensuring your documentation supports accurate reimbursement and compliance.
Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Sherri L. Clayton, RHIT, CSS. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.
Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Traditional utilization management models can no longer keep pace with regulatory shifts, payer scrutiny, and operational pressures. In this webcast, Tiffany Ferguson, LMSW, CMAC, ACM, ACPA-C, introduces an Adaptive Model strategy that modernizes UM through role specialization, technology-driven workflows, and proactive, team-based processes. Attendees will learn how to restructure programs to improve efficiency, strengthen clinical collaboration, and enhance financial performance in a rapidly changing healthcare environment.
Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Happy HIP Week! Sign up to win free access to our 2026 Coding Clinic Update Webcast Series! Click here to learn more →
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
