New ICD-10-CM Codes for FY 2023
New ICD-10-CM Codes for FY 2023 Show Sizable Increase
Change is an evitable part of life and a constant in healthcare. One thing medical coders can count on is change.
CMS has released significant ICD-10-CM changes for the fiscal year 2023 (FY 2023), with 1,176 new codes being implemented. That’s a whopping increase over the 159 new codes added for FY 2022. Furthermore, for FY 2023, 287 codes will be deleted, and 28 code descriptors will be revised.
These code changes take effect on October 1, 2022, and will remain in effect through September 30, 2023.
ICD-10-CM changes for FY 2024 are just around the corner and will take effect on October 1, 2023, which I have discussed in a recently published article.
Highlights of ICD-10-CM Code Additions By Chapter
Most of the chapters in ICD-10-CM had new codes added for FY 2023, with the majority occurring in Chapter 20: External causes of morbidity. Many of the additions in this chapter are associated with motorcycle and electric bike accidents.
Other significant code additions pertain to maternal care for fetal disorders (Chapter 15), endometriosis (Chapter 14), head injuries (Chapter 19), and dementia (Chapter 5).
Highlights of the code additions for each chapter are explained in this article. Samples of new codes are also provided. However, they are only a portion of the codes released.
You can see the full release of the ICD-10-CM code changes on the Centers for Medicare & Medicaid Services (CMS) website. There you can download:
- 2023 POA Exempt Codes
- 2023 Conversion Table
- 2023 Code Descriptions in Tabular Order
- 2023 Addendum
- 2023 Code Tables, Tabular and Index
- FY 2023 ICD-10-CM Coding Guidelines
The FY 2023 coding guidelines will also take effect on October 1. The coding guideline changes are in bold to help the coder identify the new and edited information.
Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99)
- Candidiasis of vulva and vagina has been expanded as to type
Code additions:
- B37.31, Acute candidiasis of vulva and vagina
- B37.32, Chronic candidiasis of vulva and vagina
Chapter 3: Diseases of the Blood and Blood-Forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89)
- Hemolytic-uremic syndrome
- Von Willebrand disease codes have been expanded based on type
- Thrombocytopenia
Samples of new codes:
- D59.30, Hemolytic-uremic syndrome, unspecified
- D59.31, Infection-associated hemolytic-uremic syndrome
- D68.020, Von Willebrand disease, type 2A
- D68.04, Acquired Von Willebrand disease
- D75.822, Immune-mediated heparin-induced thrombocytopenia
- D75.828, Other heparin-induced thrombocytopenia, unspecified
There is also a new code for Activated Phosphoinositide 3-kinase Delta syndrome [APDS] (D81.82).
Chapter 4: Endocrine, nutritional and metabolic diseases (E00-E89)
- Short stature due to endocrine disorder
- Acidosis based on the type
Samples of new codes:
- E34.30, Short stature due to endocrine disorder, unspecified
- E34.31, Constitutional short stature
- E34.322, Insulin-like growth factor-1 (IGF-1) resistance
- E87.21, Acute metabolic acidosis
- E87.22, Chronic metabolic acidosis
Chapter 5: Mental, Behavioral, and Neurodevelopmental Disorders (F01-F99) – 83 new codes
- Dementia has been expanded to indicate types by severity. These new codes also provide additional detail on other key associated disorders.
- Alcohol and drug use, unspecified, in remission
Samples of new codes:
- F01.52, Vascular dementia, unspecified severity, with psychotic disturbance
- F01.B3, Vascular dementia, moderate, with mood disturbance
- F02.A4, Dementia in other diseases classified elsewhere, mild, with anxiety
- F03.911, Unspecified dementia, unspecified severity, with agitation
- F03.C11, Unspecified dementia, severe, with agitation
- F10.91, Alcohol use, unspecified, in remission
Chapter 6: Diseases of the Nervous System (G00-G99)
- Limb-girdle muscular dystrophy includes the specific type and dysfunction
- Postural orthostatic tachycardia syndrome [POTS]
Samples of new codes:
- G71.031, Autosomal dominant limb-girdle muscular dystrophy
- G71.032, Autosomal recessive limb-girdle muscular dystrophy due to calpain-3 dysfunction
- G71.033, Limb-girdle muscular dystrophy due to dysferlin dysfunction
- G71.0341, Limb-girdle muscular dystrophy due to alpha sarcoglycan dysfunction
- G71.038, Other limb-girdle muscular dystrophy
- G90.A, Postural orthostatic tachycardia syndrome [POTS]
Chapter 9: Diseases of the Circulatory System (I00-I99)
- Refractory angina pectoris
- Atherosclerosis of various sites “with refractory angina pectoris”
- Malignant pericardial effusion and other pericardial effusion
- Nonrheumatic mitral (valve) annulus calcification
- Ventricular tachycardia, unspecified
- Expanded codes for different sites of aortic dissection and aneurysm with and without rupture
Samples of new codes:
- I20.2, Refractory angina pectoris
- I25.702, Atherosclerosis of coronary artery bypass graft(s), unspecified, with refractory angina pectoris
- I25.762, Atherosclerosis of bypass graft of coronary artery of transplanted heart with refractory angina pectoris
- I31.31, Malignant pericardial effusion in diseases classified elsewhere
- I31.39, Other pericardial effusion (noninflammatory)
- I34.81, Nonrheumatic mitral (valve) annulus calcification
- I47.20, Ventricular tachycardia, unspecified
- I71.012, Dissection of descending thoracic aorta
- I71.31, Pararenal abdominal aortic aneurysm, ruptured
- I71.42, Juxtarenal abdominal aortic aneurysm, without rupture
Chapter 10: Diseases of the Respiratory System (J00-J99)
Code addition:
- J95.87, Transfusion-associated dyspnea (TAD)
Chapter 11: Diseases of the Digestive System (K00-K95)
Code addition:
- K76.82, Hepatic encephalopathy
Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
- Intervertebral annulus fibrosus defect (lumbar and lumbosacral region based on size)
- Muscle wasting and atrophy (back based on region)
- Slipped upper femoral epiphysis (nontraumatic) for stable and unstable conditions based on severity and laterality. The word “stable” has been added to existing codes for upper femoral epiphysis.
- Fracture of sternum, one rib, or multiple ribs associated with chest compression and cardiopulmonary resuscitation (CPR)
- Flail chest associated with CPR
Samples of new codes:
- M51.A4, Intervertebral annulus fibrosus defect, small, lumbosacral region
- M62.5A0, Muscle wasting and atrophy, not elsewhere classified, back, cervical
- M93.012, Acute slipped upper femoral epiphysis, stable (nontraumatic), left hip
- M93.054, Acute on chronic slipped upper femoral epiphysis, unstable (nontraumatic), bilateral hips
- M96.A2, Fracture of one rib associated with chest compression and cardiopulmonary resuscitation
- M96.A4, Flail chest associated with chest compression and cardiopulmonary resuscitation
Chapter 14: Diseases of the Genitourinary System (N00-N99)
- Nephropathy based on the type
- Fournier disease of vagina and vulva
- Expanded codes for endometriosis based on depth, laterality, and site
Samples of new codes:
- N14.11, Contrast-induced nephropathy
- N14.19, Nephropathy induced by other drugs, medicaments, and biological substances
- N76.82, Fournier disease of vagina and vulva
- N80.01, Superficial endometriosis of the uterus
- N80.103, Endometriosis of bilateral ovaries, unspecified depth
- N80.129, Deep endometriosis of ovary, unspecified ovary
- N80.222, Deep endometriosis of left fallopian tube
Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A)
- Maternal care for (suspected) central nervous system (CNS) malformation or damage in fetus based on fetal site of fetus
- Maternal care for (suspected) chromosomal abnormality in fetus based on fetal site of fetus
- Maternal care for other (suspected) fetal abnormality in fetus based on fetal site of fetus
Samples of new codes:
- O35.05-, Maternal care for (suspected) central nervous system malformation or damage in fetus, holoprosencephaly
- O35.12-, Maternal care for (suspected) chromosomal abnormality in fetus, Trisomy 18
- O35.F-, Maternal care for other (suspected) fetal abnormality and damage, fetal musculoskeletal anomalies of trunk
Codes from category O35 require a 7th character to identify the number of fetus affected. A 7th charter of “0” means a single gestation; “1-5” means multiple gestations; “9” means multiple gestations greater than five. For example, O35.05X2 would be reported for maternal care for (suspected) central nervous system malformation or damage in fetus, holoprosencephaly, fetus 2.
Chapter 16: Certain Conditions Originating in the Perinatal Period (P00-P96)
- Sleep apnea in newborn children based on the specific type
Samples of new codes:
- P28.31, Primary central sleep apnea of newborn
- P28.32, Primary obstructive sleep apnea of newborn
- P28.33, Primary mixed sleep apnea of newborn
- P28.40, Unspecified apnea of newborn
- P28.43, Mixed neonatal apnea of newborn
Chapter 17: Congenital Malformations, Deformations, and Chromosomal Abnormalities (Q00-Q99)
- Atrial septal defect based on site
- Atrioventricular septal defect (partial, transitional, or complete)
- PTEN tumor syndrome
- Other Cowden syndrome
- Von Hippel-Lindau syndrome
- Other phakomatoses, not elsewhere classified
Samples of new codes:
- Q21.13, Coronary sinus atrial septal defect
- Q21.22, Transitional atrioventricular septal defect
- Q85,81, PTEN tumor syndrome
- Q85.82, Other Cowden syndrome
- Q85.83, Von Hippel-Lindau syndrome
- Q85.89, Other phakomatoses, not elsewhere classified
Chapter 19: Injury, Poisoning, and Certain Other Consequences of External Causes (S00-T88)
- Concussion with loss of consciousness status unknown
- Traumatic cerebral edema with loss of consciousness status unknown
- Traumatic brain injury (diffuse or unspecified focal) with loss of consciousness status unknown
- Contusion and laceration of cerebrum based on laterality with loss of consciousness status unknown
- Hemorrhage (epidural, traumatic subdural, or subarachnoid) with loss of consciousness status unknown
- Internal carotid artery injury based on laterality, intracranial portion, not elsewhere classified with loss of consciousness status unknown
- Primary blast injury, not elsewhere classified (with many new codes added)
- Poisoning by, adverse effect of, and underdosing of methamphetamines
Samples of new codes:
- S06.0XA-, Concussion with loss of consciousness status unknown
- S06.1XA-, Traumatic cerebral edema with loss of consciousness status unknown
- S06.2XA-, Diffuse traumatic brain injury with loss of consciousness status unknown
- S06.30A-, Unspecified focal traumatic brain injury with loss of consciousness status unknown
- S06.33A-, Contusion and laceration of cerebrum, unspecified, with loss of consciousness status unknown
- S06.4XA-, Epidural hemorrhage with loss of consciousness status unknown
- S06.82A-, Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness status unknown
- S06.8A7-, Primary blast injury of brain, not elsewhere classified with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness
- T43.653-, Poisoning by methamphetamines, assault
Codes from categories S06 and T43 require a 7th character to identify the episode of care (A-initial; D-subsequent; S-sequela). For example, S06.1XAD would be reported for traumatic cerebral edema with loss of consciousness status unknown, subsequent encounter. T43.653A would be reported for poisoning by methamphetamines, assault, initial encounter.
Chapter 20: External Causes of Morbidity (V00-Y99)
- Electric (assisted) bicycle and other motorcycle accidents
Samples of new codes:
- V20.11-, Electric (assisted) bicycle passenger injured in collision with pedestrian or animal in nontraffic accident
- V22.39-, Person boarding or alighting other motorcycle injured in collision with two- or three-wheeled motor vehicle
- Y25.99-, Unspecified rider of other motorcycle injured in collision with railway train or railway vehicle in traffic accident
- V27.21-, Unspecified electric (assisted) bicycle rider injured in collision with fixed or stationary object in nontraffic accident
- V29.99-, Rider (driver) (passenger) of other motorcycle injured in unspecified traffic accident
Codes from Chapter 19 require a 7th character to identify the episode of care (A-initial; D-subsequent; S-sequela). For example, V27.21XD would be reported for unspecified electric (assisted) bicycle rider injured in collision with fixed or stationary object in nontraffic accident, subsequent encounter.
Chapter 21: Factors Influencing Health Status and Contact with Health Services (Z00-Z99)
- Encounter for observation
- Expanded social determinants of health (SDOH) codes
- Long-term (current) use of new medications
- Personal history of diseases (corrected)
- Patient’s noncompliance (intentional or otherwise)
- Caregiver’s noncompliance (intentional or otherwise)
Samples of new codes:
- Z71.87, Encounter for observation for pediatric-to-adult transition counseling
- Z59.82, Transportation insecurity
- Z59.86, Financial insecurity
- Z59.87, Material hardship
- Z79.631, Long-term (current) use of antimetabolite agent
- Z87.761, Personal history of (corrected) gastroschisis
- Z91.118, Patient’s noncompliance with dietary regimen for other reason
- Z91.A10, Caregiver’s noncompliance with patient’s dietary regimen due to financial hardship
Six Chapters With No Code Additions
There were no code additions made to the following chapters for FY 2023:
- Chapter 2: Neoplasms (C00-D49)
- Chapter 7: Diseases of the eye and adnexa (H00-H59)
- Chapter 8: Diseases of the ear and mastoid process (H60-H95)
- Chapter 12: Diseases of the skin and subcutaneous tissue (L00-L99)
- Chapter 18: Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99).
- Chapter 22: Codes for special purposes (U00-U85)
Although Chapter 2 did not include any new codes, there have been 11 changes made to codes for peripheral T-cell lymphoma. Instead of saying “not classified,” the descriptors now say “not elsewhere classified.”
Samples of new codes:
- C84.40, Peripheral T-cell lymphoma, not elsewhere classified, unspecified site
- C84.43, Peripheral T-cell lymphoma, not elsewhere classified, intra-abdominal lymph nodes
- C84.47, Peripheral T-cell lymphoma, not elsewhere classified, spleen
Chapters 7, 8, 12, 18, and 22 had no code additions, changes, or deletions.
Again, these are the highlights for the new ICD-10-CM code changes effective October 1, 2022, for FY 2023. To see the complete list, go to the CMS website. You will need to know these code changes if you plan to sit for a certification exam in 2023.
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