Industry experts and coders alike will be pleased to see the inclusion of 69 new codes to further identify the stage of severity, and behavioral and psychological symptoms of dementia (BPSD).
 
These were included as part of the 1,176 new codes released June 10 as part of the FY2023 ICD-10 final code update. The code update also includes a couple hundred Tabular and Alpha Index changes. The CDC has also posted the FY2023 guidelines along with the code update. These changes will take effect Oct. 1.
  
Although codes currently exist for dementia with and without behavioral disturbances, there is a need for additional detail on other key associated disorders, particularly psychotic disorders, mood disorders and anxiety, the proposals stated.
 
Some of the new 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)
  • F02.C11 (Dementia in other diseases classified elsewhere, severe, with agitation)
These are just four of the 83 new codes added to Chapter 5 (Mental, Behavioral and Neurodevelopmental disorders (F01-F99).
 
A new guideline was added for the assignment of dementia (categories F01, F02 and F03), which states that selection of the appropriate severity level (unspecified, mild, moderate or severe) “requires the provider’s clinical judgment and codes should be assigned only on the basis of provider documentation unless otherwise instructed by the classification.  If the documentation does not provide information about the severity of the dementia, assign the appropriate code for unspecified severity.”
 
In addition to the 1,176 new codes, this update also includes 28 codes that had revisions to their descriptors, and 287 codes deemed invalid. One example of a code description revision is F02.80 (Dementia in other diseases classified elsewhere without behavioral disturbance), which will be revised to F02.80 (Dementia in other diseases classified elsewhere, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety).
 
More highlights of the final update
  • Chapter 9 (Circulatory) will expand with the addition of 43 new codes including I20.2 (Refractory angina pectoris) and I25.112 (Atherosclerosic heart disease of native coronary artery with refractory anginapectoris).
  • Section S00-S09 (Injuries to the head) will see 86 new code additions related to head injuries including concussion codes: S06.0XAA (Concussion with loss of consciousness status unknown, initial encounter), S06.0XAD (Concussion with loss of consciousness status unknown, subsequent encounter) and S06.0XAS (Concussion with loss of consciousness status unknown, sequela).
  • Three new codes will be added to category Z55 - Z65 (Persons with potential health hazards related to socioeconomic and psychosocial circumstances), including Z59.82 (Transportation insecurity) with inclusion terms: “Excessive transportation time,” “Inaccessible transportation,” “Inadequate transportation,” “Lack of transportation,” “Unaffordable transportation,” “Unreliable transportation and Unsafe transportation”, Z59.86 (Financial insecurity) with inclusion terms: “Bankruptcy,” “Burdensome debt,” “Economic strain,” “Financial strain,” “Money problems,” “Running out of money” and “Unable to make ends meet”, and Z59.87 (Material hardship) with inclusion terms: “Material deprivation,” “Unable to obtain adequate childcare,” “Unable to obtain adequate clothing,” “Unable to obtain adequate utilities” and “Unable to obtain basic needs.”
  • Category Z79 (Long term (current) drug therapy) will see the addition of 15 new codes 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 (Long-term (current) use of injectable non-insulin antidiabetic drugs).
  • A new guideline for underdosing explains that you don’t need to see a change in the patient’s condition to assign an underdosing code. “Documentation that the patient is taking less of a medication than is prescribed or discontinued the prescribed medication is sufficient for code assignment,” according to new language added to the underdosing guideline in chapter 19 (Injury, poisoning and certain other consequences of external causes [S00-T88]).
 
Editor’s note: To view the final code update, visit https://tinyurl.com/7amyk6st