News: FY 2023 ICD-10-CM code set released

The Centers for Disease Control and Prevention (CDC) recently released the fiscal year (FY) 2023 ICD-10-CM code set and ICD-10-CM Official Guidelines for Coding and Reporting, introducing new codes and guidance for reporting dementia, head injuries, and long-term drug therapy.

The 2023 ICD-10-CM update includes 1,176 new, 28 revised, and 287 deleted codes to be used for patient encounters and discharges occurring from October 1, 2022 through September 30, 2023. Eighty-three new codes were added to Chapter 5 (Mental, Behavioral and Neurodevelopmental disorders [F01-F99]) of ICD-10-CM, including 69 new codes for dementia with and without psychological symptoms. A few of the new dementia codes include:

• F02.811, dementia in other diseases classified elsewhere, unspecified severity, with agitation
• F02.A11, dementia in other diseases classified elsewhere, mild, with agitation
• F02.B11, dementia in other diseases classified elsewhere, moderate, with agitation

New guidelines for reporting dementia emphasize that providers must clearly document the severity of the patient’s condition. If the documentation is incomplete, the coder should default to the appropriate unspecified code. In addition, the updated guidelines stipulate that if a patient with dementia is admitted to an inpatient facility and gets worse during their stay, the coder should assign the highest severity level reported during the stay.

Coders will also find 86 new codes related to head injuries including the following concussion codes: 

• 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

New language in Chapter 19 (Injury, poisoning, and certain other consequences of external causes [S00-T88]) clarifies that coders do not need to see a change in the patient’s condition to assign an underdosing code. According to the updated guidelines, “Documentation that the patient is taking less of a medication than is prescribed or discontinued the prescribed medication is sufficient for code assignment.”

In addition, 15 new codes were added to ICD-10-CM category Z79 (long-term [current] drug therapy) including Z79.85 (long-term [current] use of injectable non-insulin antidiabetic drugs). A new guideline was added to Chapter 4 (Endocrine, Nutritional, and Metabolic Diseases) advising that if the patient is treated with both insulin and an injectable non-insulin antidiabetic drug, assign codes Z79.4 (long-term [current] use of insulin) and Z79.85 (long-term [current] use of injectable non-insulin antidiabetic drugs). If the patient is treated with both oral hypoglycemic drugs and an injectable non-insulin antidiabetic drug, assign codes Z79.84 (long-term [current] use of oral hypoglycemic drugs) and Z79.85.

Other notable updates include new codes for heart disease, injuries due to motor vehicle collisions, and new guidelines in Chapter 15 (Pregnancy, childbirth and the puerperium [O00-O9A]) for calculating weeks of gestation.  

For more information and to read the updated FY 2023 guidelines and code set in their entirety, visit the CMS website.

Editor’s Note: This article was originally published in JustCoding, which can be accessed here. To read the FY 2023 ICD-10-CM code set released by the CDC, click here.