Spring Brings Code Meetings and Updates

We are approaching April 1, which means that ICD-10-CM and ICD-10-PCS will be updated with their respective guidelines.

The Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS) have released the code and guideline updates. This article will focus on the updates that are continued from the October fiscal year (FY) 24 edition or are new to the April version of the ICD-10-CM FY24 guidelines.

The updates include the following:

• C.1.d.5.b – Sepsis due to postprocedural infection. There is an addition of code T81.49 (Infection following a procedure, other surgical site) and O86.09 (Infection of obstetric surgical wound, other surgical site).

• C.1.g.1.f – Screening for COVID-19. For screening for COVID-19, including preoperative testing, assign Z11.52 (Encounter for screening for COVID-19). This change was made due to the declaration that the pandemic was over.

• C.4.a.6.b.i. – Secondary diabetes mellitus due to pancreatectomy. Assign a code from category E13 as the principal or first-listed diagnosis.

• C.18.e – Coma. Code R40.20 (Unspecified coma) should be assigned when the underlying cause of the coma is not known or the cause is a traumatic brain injury and the coma scale is not documented in the medical record.

• C.18.i – NIHSS Stroke Scale – a minor change was made to the code range which is now listed as I60 – I63.

• C.19.e.5.c – Underdosing. There is an update to the code range for noncompliance with the addition of Z91.A4- (Caregiver’s other noncompliance with patient’s medication regimen).

• C.21.c.7 – Aftercare. These codes (referring to Z codes) are to be first listed, followed by the diagnosis code when a patient’ encounter is chiefly to receive radiation therapy, chemotherapy, or immunotherapy for the treatment of a neoplasm.

• C.21.c.8 – Follow-up. Addition of this explanation, “Codes Z08 (Encounter for follow-up examination after completed treatment for malignant neoplasm) and Z09 (Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm) may be assigned following any type of completed treatment modality (including both medical and surgical treatment).

Remember the Coordination and Maintenance Committee meeting is next week on March 19 and 20. The CPT® Editorial Panel meeting is scheduled for May 9 through May 11. There are links in the resources if you have not registered yet. You must register for free to attend.

You may claim continuing education credits for attending. A copy of the agenda is proof of your attendance.

Resources:

https://www.ama-assn.org/about/events/cpt-editorial-panel-meeting

https://www.cdc.gov/nchs/icd/icd10cm_maintenance.htm

https://www.cms.gov/medicare/coding-billing/icd-10-codes/icd-10-coordination-maintenance-committee-meetings

https://www.cms.gov/medicare/coding-billing/icd-10-codes/2024-icd-10-cm