395 New ICD-10-CM Codes (FY 2024) Are Coming
Change is an inevitable and integral part of life, and nowhere is it more constant than in the ever-evolving healthcare field. Medical coders are well aware of this as they encounter continuous updates and modifications. Notably, the Centers for Medicare and Medicaid Services (CMS) has recently approved a comprehensive set of ICD-10-CM changes for the upcoming fiscal year. As we move into FY 2024, nearly every chapter of the code set will be impacted by new ICD-10-CM codes, and numerous chapters will incorporate new and revised instructional notes.
Within the new code set is an impressive 395 new codes, along with 13 revisions to existing codes and 25 code deletions. While this may seem substantial, it’s worth noting that this figure pales in comparison to the previous fiscal year, which saw a staggering 1,176 new codes added.
Despite the sheer volume of modifications, medical coders must be prepared to embrace these changes as they are slated to take effect on October 1, 2023, and will remain applicable through September 30, 2024. The corresponding FY 2024 coding guidelines will also take effect on October 1, with specific text in bold print to help the coder identify the new and edited information.
Four Chapters With Significant Code Additions in FY 2024
According to the Centers for Medicare & Medicaid Services (CMS), Chapters 20, 13, 7, and 21 see the most significant number of new codes for FY 2024.
Chapter 20: External causes of morbidity (V00-Y99)
This chapter sees a major shift with 123 new codes specifically designed to capture accidents and injuries involving items entering through natural orifices. For example, codes like W44.A1XA represent incidents of a button battery entering into a natural orifice during the initial encounter. At the same time, W44.B2XD depicts a subsequent encounter of a plastic coin entering into a natural orifice.
Chapter 13: Diseases of the musculoskeletal system and connective tissue (M00-M99)
Chapter 13 introduces 36 new codes. For example, new codes have been created to enable more specific reporting of age-related and other osteoporosis cases with current pathological pelvic fractures, like M80.0B1 for age-related osteoporosis with a current pathological fracture in the right pelvis.
Chapter 7: Diseases of the eye and adnexa (H00-H59)
You can expect to see 34 new codes In Chapter 7. For instance, category H36, Retinal Disorders in Diseases Classified Elsewhere, is being expanded to provide more specificity regarding nonproliferative and proliferative sickle-cell retinopathy and other retinal disorders in diseases classified elsewhere. New code examples include H36.811 for nonproliferative sickle-cell retinopathy, right eye, and H36.832 for proliferative sickle-cell retinopathy, bilateral. Additionally, new codes are introduced under category H50, Other Strabismus, focusing on mechanical strabismus and reporting specific eye muscle entrapment, like H50.632 for inferior rectus muscle entrapment in the left eye and H50.679 for superior rectus muscle entrapment in an unspecified eye.
Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)
Chapter 21 brings 30 new Z codes to capture various situations, such as an encounter for a child welfare exam (Z02.84), personal history of military service (Z91.85), and family history of colonic polyps with several codes for added specificity (Z83.710 – Z83.719). New codes also address resistance to carbapenem (Z16.13) and reporting carriers of other specified bacterial diseases (e.g., Z22.340). Additionally, there are codes for encounters related to HIV pre-exposure prophylaxis measures (Z29.81) and other specified prophylactic measures (Z29.89). Furthermore, Z codes have been established to address patient caregivers’ noncompliance with the patient’s medical treatment and regimen, like Z91.A41 for caregiver’s noncompliance with the patient’s medication regimen due to financial hardship.
Lastly, let’s not forget the new Social Determinants of Health (SDOH) Z codes in Chapter 21, which address upbringing-related issues and specific problems like a child in custody of a non-parental relative (Z62.23) or running away from the current living environment (Z62.892).
Other Chapters See Code Additions
According to the CMS Tabular Addenda, below are some key highlights of code additions you can expect to see on October 1, 2023, from other chapters.
Chapter 1: Certain infectious and parasitic diseases (A00-B99)
Two new codes were created — one to describe Sepsis due to Acinetobacter baumannii (A41.54) and one for Acinetobacter baumannii as the cause of diseases classified elsewhere (B96.83).
Chapter 2: Neoplasms (C00-D49)
Several new codes were introduced for desmoid tumor, classified according to anatomical site. Example: D48.115 (Desmoid tumor of upper extremity and shoulder girdle).
Chapter 3: Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)
New codes were established for sickle-cell disorders, like D57.214 (Sickle-cell/Hb-C disease with crisis). In addition, a new code was created for Schwachmon-Diamond syndrome (D61.02), an inherited condition associated with aplastic anemia.
Chapter 4: Endocrine, nutritional, and metabolic diseases (E00-E89)
Hypoparathyroidism has a new set of codes under E20.8 to capture the condition due to impaired parathyroid hormone secretion. Example: E20.812 Autoimmune hypoparathyroidism. Additionally, new codes were introduced for metabolic syndrome and insulin resistance, including E88.810, E88.811, E88.818, and E88.819.
Chapter 6: Diseases of the nervous system (G00-G99)
Parkinson’s disease codes are being expanded to include motor fluctuations and dyskinesia. Codes introduced include G20.A1, G20.A2, G20.B1, G20.B2, and G20.C. In addition, codes for chronic migraine with aura have been expanded to include six new codes indicating not intractable and tractable, as well as with and without status migrainosus. Example: G43.E09 Chronic migraine with aura, not intractable, without status migrainosus.
Chapter 9: Diseases of the circulatory system (I00-I99)
FY 2024 adds a new code to this chapter, I1A.0 (Resistant hypertension). Three new codes associated with supraventricular tachycardia have been introduced and include I47.10 (Supraventricular tachycardia, unspecified), I47.11 (Inappropriate sinus tachycardia, so stated), and I47.19 (Other supraventricular tachycardia). Additionally, a revision in the code descriptions for aneurysms of the abdominal aorta will be updated as follows: I71.51 (Supraceliac aneurysm of the thoracoabdominal aorta, ruptured), and I71.52 (Paravisceral aneurysm of the thoracoabdominal aorta, ruptured)
Chapter 10: Diseases of the respiratory system (J00-J99)
Three new codes have been introduced to address chronic lung allograft dysfunction and include J4A.0 (Restrictive allograft syndrome), J4A.8 (Other chronic lung allograft dysfunction), and J4A.9 (Chronic lung allograft dysfunction, unspecified).
Chapter 11: Diseases of the digestive system (K00-K95)
FY 2024 has created six new codes for more specific reporting of acute appendicitis with generalized peritonitis and are assigned with codes K35.200-K35.219. Example: K35.219 (Acute appendicitis with generalized peritonitis, with abscess, unspecified as to perforation). Additionally, there are new codes to identify short bowel syndrome with and without colon in continuity, and short bowel syndrome, unspecified, such as K90.821 (Short bowel syndrome with colon in continuity). A new code for intestinal failure has also been added (K90.83).
Chapter 14: Diseases of the genitourinary system (N00-N99)
A new parent code and seven new child codes have been added to report recurrent and persistent immunoglobulin A nephropathy. Example: N02.B3 (Recurrent and persistent immunoglobulin A nephropathy with diffuse membranoproliferative glomerulonephritis). Other nephrology codes, N04.2 and N06.2, are now parent codes and include several child codes for more specificity. Examples: N04.20 (Nephrotic syndrome with diffuse membranous glomerulonephritis, unspecified) and N06.20 (Isolated proteinuria with diffuse membranous glomerulonephritis, unspecified).
Chapter 15: Pregnancy, childbirth, and the puerperium (O00-O9A)
A new parent code, O26.64, has been added for Intrahepatic cholestasis of pregnancy, with four new child codes based on trimester. Example: O26.642 Intrahepatic cholestasis of pregnancy, second trimester.
Chapter 17: Congenital Malformations, Deformations, and Chromosomal Abnormalities (Q00-Q99)
Craniosynostosis, listed under other congenital malformations of skull and face bones, has received several new codes classified according to the type of suture closure (Unspecified, Sagittal, Coronal, metopic, Lamboid, Multi-suture, and Other). Examples: Q75.022 (Coronal craniosynostosis bilateral) and Q75.01 (Sagittal craniosynostosis).
Chapter 18: Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
Several new codes have been created to indicate the levels of breast density detected on a mammogram and specify the breast involved (right, left, bilateral). Example: R92.331 (Mammographic heterogeneous density, right breast).
Chapter 19: Injury, poisoning, and certain other consequences of external causes (S00-T88)
Four new codes for toxic effects of gadolinium have been added, including the cause (unintentional, intentional self-harm, assault, undetermined). These codes are reported with new codes T56.821-T56.824. Example: T56.822 (Toxic effect of gadolinium, intentional self-harm).
Five Chapters With No Code Additions
No code additions have been made to the following chapters for FY 2024:
- Chapter 5: Mental, behavioral, and neurodevelopmental disorders (F01-F99)
- Chapter 8: Diseases of the ear and mastoid process (H60-H95)
- Chapter 12: Diseases of the skin and subcutaneous tissue (L00-L99)
- Chapter 16: Certain conditions originating in the perinatal period (P00-P96)
- Chapter 22: Codes for special purposes (U00-U85)
Table of Changes for FY 2024 (Additions, Revisions, and Deletions)
According to Decision Health, the following table depicts the final coding updates per chapter for FY 2024.
For the complete list of FY 2024 ICD-10-CM code changes, please refer to the Centers for Medicare & Medicaid Services (CMS) website. You will not be tested on these code changes in 2023; however, you will need to know them on a certification exam in 2024.