Every year, CMS issues clarifications, additions and deletions to diagnosis codes that become effective on October 1, 2023. For 2024, CMS announced 395 new diagnosis codes, 25 deletions and 13 revisions. Although there are many changes in wording, synonyms and instructional notations, below are the most salient code changes but please note that this is not an exhaustive list. Do check CMS directly for a list of ICD-10-CM codes in effect for 2024 as all providers are responsible for reporting accurate codes on their effective dates. Our focus, as always, is adult primary care and codes that are, or could be, risk adjusted.
Chapter 2: The code category of Neoplasms of uncertain behavior of connective and other soft tissue grew to accommodate new codes for desmoid tumors (D48.11-) of various locations.
Chapter 3: Sickle-cell thalassemia (D57.4) expanded to include other complications, and there was a small code expansion to aplastic anemia. Codes were created for the association of COVID to certain coagulopathies (D68).
Chapter 4: Hypoparathyroidism (E20.8) grew to include other specific types, such as autoimmune, secondary, etc. Metabolic disorders in E88 saw several new codes, and cachexia (R64) now has a counterpart (E88.A) called wasting disease (syndrome) due to underlying condition with an Excludes1 notation.
Chapter 6: Parkinson’s disease (G20) split into codes reflecting the disease with (G20.A) or without (G20.B) dyskinesia. Parkinsonism, unspecified will be coded G20.C. Similarly, epilepsy received new codes for lafora progressive myoclonus epilepsy (G40.C). Chronic migraine with aura (G43.1) also saw an expansion in codes, as did Other & unspecified encephalopathy (G93.4).
Chapter 7: Retinal disorders (H36) spawned new codes for two types of sickle-cell retinopathy (in H36.8), and mechanical strabismus (H50.6) expanded to include various codes for specific muscle entrapments. Lastly, a new code for Foreign body sensation eye (ocular) was created (H57.8).
Chapter 9: A new code for resistant hypertension (I1A.0) was created and other forms of angina (I20.8) was divided slightly into two codes. The distinction of microvascular disease was added to acute MI and chronic ischemic heart disease, creating a few new codes. Supraventricular tachycardia (I47.1) was further divided to reflect greater diagnostic specificity, and various new notations were added to this important chapter.
Chapter 10: Bronchiolitis obliterans was added to other COPD (J44.8) and for emphysema (J43), the Excludes1 became an Excludes2.
Chapter 11: No big changes in this chapter except a few Excludes1s becoming Excludes2s and the addition of short bowel syndrome (K90.82) and Intestinal failure (K90.83).
Chapter 13: Osteoporosis with pathological fracture (M80.0 and M80.8) has new codes for laterality.
Chapter 14: Code category Glomerular diseases birthed new codes for recurrent and persistent hematuria (N02), nephrotic syndrome (N04) and a type of isolated proteinuria (N06).
Chapter 17: This section has some changes in coding congenital conditions, including new codes for liver malformations and craniosynostosis.
Chapter 18: A new code for Foreign body sensation of the circulatory and respiratory system (R09.A) was created and several new codes representing Mammographic density found on imaging of breast (R92.3) will be in use next year.
Chapter 19: Toxic effect of gadolinium (T56.82) was created with several contexts.
Chapter 20: As we’ve seen, new foreign body codes were created for the eyes, circulatory and respiratory system. This chapter incudes several more under the heading Foreign body entering into or through a natural orifice (W44) for items such as batteries, plastic, glass and other objects.
Chapter 21: Be sure to carefully check this section entitled Factors influencing health status and contact with health services for many new codes and notations. The most notable are the expansion of Family history of adenomatous and serrated polyps (Z83.71), Personal history of military service (Z91.85), expansion in caregiver noncompliance codes (Z91.A) and the creation of codes for carriers of certain conditions.
Chapter 22: This chapter is for special uses and so far, only contains codes for vaping and COVID. The latter saw an important “use additional code” notation for associated conditions.
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