Key ICD-10-CM Code Updates for 2023

Category: Health

Key ICD-10-CM Code Updates for 2023

Summary: Providers of medical coding services help physicians report diagnoses correctly using the latest ICD-10 codes and submit accurate claims for appropriate reimbursement.

ICD-10 codes and guidelines have been developed to assist both the healthcare provider and coders in identifying and reporting diagnoses. In recent years the number of codes released by the standard bodies has been on the rise. Medical coding and billing outsourcing companies stay updated on code changes to help physicians report diagnoses correctly, comply with regulatory requirements, submit accurate claims, and ensure appropriate reimbursement.

The 2023 ICD-10 codes that came into effective in April 2023 are to be used for discharges from October 1, 2022, through September 30, 2023, and for patient encounters from October 1, 2022, through September 30, 2023. The April 2023 ICD-10 code updates include 42 new codes, 7 code deletions, and one revised code.

Highlights of the 2023 ICD-10-CM Codes

• Social determinants of health (SoDH) code updates

Chapter 21 (Factors influencing status and contact with health services- Z00-Z99) has new social determinants of health codes to report factors that may prevent a patient from obtaining care or complying with recommended treatment. The new SoDH codes include:

Z55.6 Problems related to health literacy

Z59.82 – Transportation Insecurity

Z59.86 – Financial hardship

Z59.87 – Material hardship

Under Z59.8, a newly added Excludes2 note indicates the appropriate codes for extreme poverty, financial insecurity, low income, and material hardship. Under Z59.82 Transportation insecurity, an Excludes2 note is added to direct the coder to Z75.3 for unavailability and inaccessibility of healthcare facilities.

• Dementia code updates

In recognition of the growing incidence of dementia, Chapter 5: Mental, Behavioral and Neurodevelopmental Disorders has 87 new codes to report more detailed information on dementia severity and associated behavioral disorders. Updated code classifications to identify dementia with behavioral disturbances include:

F01.A1 – Vascular dementia, mild

F01.B1 – Vascular dementia, moderate

F01.C1 – Vascular dementia, severe

F02.A1 – Dementia in other diseases classified elsewhere, mild

F02.B1 – Dementia in other diseases classified elsewhere, moderate

F02.C1 – Dementia in other diseases classified elsewhere, severe

F03.A1 – Unspecified dementia, mild

F03.B1 – Unspecified dementia, moderate

F03.C1 – Unspecified dementia, severe

The 2023 ICD-10-CM official guidelines state: “The ICD-10-CM classifies dementia (categories F01, F02, and F03) on the basis of the etiology and severity (unspecified, mild, moderate or severe). Selection of the appropriate severity level requires the provider’s clinical judgment and codes should be assigned only on the basis of provider documentation (as defined in the Official Guidelines for Coding and Reporting), 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.

Endometriosis code updates

The endometriosis code selections are drastically expanding from 9 to 135 codes To avoid unspecified diagnosis codes, surgeons must document the specific location of endometriosis and the depth, either superficial or deep. For example, endometriosis of the ovary(ies) was previously reported with one code:

N80.1 Endometriosis of ovary.
For FY 2023, there are 12 different code selections:

N80.101— Endometriosis of right ovary, unspecified depth

N80.102 — Endometriosis of left ovary, unspecified depth

N80.103 — Endometriosis of bilateral ovaries, unspecified depth

N80.109 — Endometriosis of ovary, unspecified side, unspecified depth

N80.111 — Superficial endometriosis of right ovary

N80.112 — Superficial endometriosis of left ovary

N80.113 — Superficial endometriosis of bilateral ovaries

N80.119 — Superficial endometriosis of ovary, unspecified ovary

N80.121 — Deep endometriosis of right ovary

N80.122 — Deep endometriosis of left ovary

N80.123 — Deep endometriosis of bilateral ovaries

N80.129 — Deep endometriosis of ovary, unspecified ovary

The expanded code for endometriosis of the pelvic peritoneum take into account the specific locations of anterior or posterior cul-de-sac; left, right, or bilateral pelvic sidewall; left, right, or bilateral pelvic brim; pelvic peritoneum; other specified sites. There are also codes for specific parts of the intestine as well as specific organs and nerves.

N80.0- (Endometriosis of uterus) also has more specific codes:

N80.00 (Endometriosis of the uterus, unspecified)

N80.01 (Superficial endometriosis of the uterus)

N80.02 (Deep endometriosis of the uterus)

N80.03 (Adenomyosis of the uterus)

• Maternal care for fetal disorders

There are 200 new codes in Chapter 15: Pregnancy, Childbirth and the Puerperium (O00-O9A) to more accurately represent a large number of specific fetal conditions that were not represented adequately previously.

• Head injuries

The 2023 ICD-10 include 86 new codes for concussion, traumatic brain injury, cerebral edema, and hemorrhage when it is not known whether the patient lost consciousness at the time of the injury. Examples of new concussion codes: 

S06.0XAA, concussion with loss of consciousness status unknown, initial encounter

S06.0XAD, concussion with loss of consciousness status unknown, subsequent encounter

S06.0XAS, concussion with loss of consciousness status unknown, sequela

When reporting these codes, also code open wound of head (S01.-) and/or skull fracture (S02.-). If applicable, an additional code should be used to identify mild neurocognitive disorders due to known physiological condition (F06.7-).

There are also 15 new codes in ICD-10 category Z79 (long-term [current] drug therapy) including Z79.85 (long-term [current] use of injectable non-insulin antidiabetic drugs). The updates also include new codes for heart disease, injuries due to motor vehicle collisions, and new guidelines in Chapter 15 (Pregnancy, childbirth and the puerperium [O00-O9A]) for calculating weeks of gestation.  

Additional ICD-10 Code Updates in April 2023

On April 1, 2023, CMS announced the release of 42 new ICD-10-CM codes, seven code deletions, and one revised code. The new ICD-10 codes are in Chapters 19, 20, and 21.

Importance of Complete Clinical Documentation

ICD-10 guidelines emphasize the importance of consistent, complete documentation in the medical record. Coders should review the entire record to determine the specific reason for the encounter and the conditions treated. Physicians need to keep in mind that without proper and complete documentation, even an experienced medical coding company cannot assign the correct codes.