Every year, the World Health Organization (WHO) revises and publishes updates to the ICD-10-CM diagnosis codes. These updates are effective October 1 – September 30.
In addition to the ICD-10-CM updates, the Centers for Medicare and Medicaid Services (CMS) and the National Center of Health Statistics (NCHS) updates the Official Guidelines for Coding and Reporting. The guidelines are approved by the American Hospital Association (AHA) and the American Health Information Management Association (AHIMA). Adherence to these guidelines when assigning ICD-10-CM diagnosis codes is required under the Health Insurance Portability and Accountability Act (HIPAA).
The updates to the ICD-10-CM codes for FY 2024 include 395 new healthcare codes. In addition to the new codes added, the WHO also deleted 25 diagnosis codes and revised 13. Several of these updates will likely impact Risk Adjustment and HCC diagnosis codes.
ICD-11, which came into effect in January 2022, is the future and was endorsed by the WHO in 2019. However, the U.S. has not implemented this code set.
The transition from a fee-for-service to a value-based healthcare model has driven many of these updates. The new reimbursement model is based upon the quality of care provided. To accurately reflect and capture the acuity of the patient and care provided, the emphasis is on more complete documentation with greater focus on ICD-10-CM code specificity.
Complete and detailed documentation leads to accurate coding, and accurate coding leads to timely claims reimbursement. Accurate documentation also results in better and more effective patient care. It can also provide more detailed information to other healthcare providers managing patient care.
Below are several examples of the 395 new diagnosis codes for FY 2024.
- (D13) Benign neoplasm of digestive system now includes type
- (D48) Desmoid tumor now includes site
- (D57) Sickle-cell thalassemia now includes type
- (E20) Hypoparathyroidism now includes type
- (E88) Metabolic Syndrome now includes type
- (G20) Parkinson’s disease now includes type
- (G37) Demyelinating disease now includes type
- (G40) Epilepsy now includes new specified type
- (G43) Chronic migraine now includes with aura
- (H36) Retinal disorders now includes type and laterality
- (H50) Other strabismus now includes new specified type and laterality
- (I1A) New category for Resistant Hypertension
- (I20) Angina now includes new type
- (I47) Supraventricular tachycardia now includes specified types
- (K35) Acute appendicitis now includes with or without perforation
- (M80) Age-related osteoporotic fractures includes additional locations