CMS releases proposed 2023 ICD-10 codes

Proposed ICD-10-CM code changes released with the FY2023 Hospital Inpatient PPS (IPPS) proposed rule on April 18th introduced 1,179 new codes including several code additions to further identify the stage of severity as well as behavioral and psychological symptoms of dementia (BPSD).

 

A proposal including several of these dementia codes was previously discussed during at the virtual ICD-10-CM Coordination and Maintenance Committee meetings in both March & September 2021.

 

Although codes exist for dementia without and with behavioral disturbances, there is a need for additional detail on other key associated disorders, particularly psychotic disorders, mood disorders, and anxiety, the proposal stated.

 

Some of the new codes proposed 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)

 

The new proposed code changes also include a reissue the COVID-19 vaccine status-related codes that were previously implemented on April 1. They are: Z28.310 (Unvaccinated for COVID-19), Z28.311 (Partially vaccinated for COVID-19) and Z28.39 (Other underimmunization status).

 

This update also includes 28 revised codes and 288 codes deemed invalid. If finalized, these changes would take effect Oct. 1.

 

 

The cardiovascular system chapter will expand if the proposal to delete and replace 10 codes for conditions such as noninflammatory pericardial effusion (I31.3), ventricular tachycardia (I47.2) and thoracic aneurysm with rupture (I71.1) and without rupture (I71.2) are finalized.

 

In the musculoskeletal and connective tissue chapter, the word “stable” will be added to existing codes for slipped upper femoral epiphysis. For example, M93.011 (Acute slipped upper femoral epiphysis, stable [nontraumatic], right hip) to make room for changes to the code set than include codes for unstable slipped upper femoral epiphysis.

 

The chapter for factors influencing health status will replace non-compliance codes Z91.11 (Patient's noncompliance with dietary regimen) and Z91.19 (Patient's noncompliance with other medical treatment and regimen) with codes that describe the reason for non-compliance.

 

 

• More than 85 new code additions related to head injuries are proposed in section S00-S09 (Injuries to the head) 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).
• The bulk of new code changes occurred in Chapter 20 (External Causes of Morbidity) with over 450 additions proposed. This chapter permits the classification of environmental events and circumstances as the cause of injury and other adverse effects. Some of the new codes proposed include V20.09XA (Other motorcycle driver injured in collision with pedestrian or animal in nontraffic accident, initial encounter), V20.09XD (Other motorcycle driver injured in collision with pedestrian or animal in nontraffic accident, subsequent encounter) and V20.09XS (Other motorcycle driver injured in collision with pedestrian or animal in nontraffic accident, sequela).