The healthcare industry is no stranger to constant updates, especially when it comes to coding and billing. As medical knowledge advances, disease trends change, and the healthcare landscape evolves, the Centers for Medicare & Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) update the 2024 ICD-10-CM Code set every year
Healthcare providers, medical coders, and Medical billing professionals must remain informed about these updates so that coding is accurate and compliance with federal and payer regulations is ensured. The reporting and reimbursement of diagnoses will be impacted by several new, revised, and deleted codes in 2024.
We’ll explore the 2024 ICD-10-CM code changes in this newsletter, including key revisions, their implications, and strategies for ensuring a smooth transition.
Why 2024 ICD-10-CM Code Updates Are Important
All healthcare settings use ICD-10-CM for coding diagnoses, including outpatient clinics and hospitals. Accurate coding is important for several reasons:
- Patient Care: An accurate diagnosis code aids providers in making informed clinical decisions, which leads to better patient outcomes.
- Reimbursement: Medicare and Medicaid reimburse claims using ICD-10-CM codes. If the codes are incorrect, claims may be denied or payments reduced.
- Data Reporting: Data from ICD-10-CM are used by public health organizations to monitor disease trends, evaluate healthcare interventions, and make policy decisions.
Consequently, updates to ICD-10-CM codes directly affect patient care, reimbursements, and data collection across the healthcare ecosystem. Providers must implement these changes in order to avoid compliance issues and ensure efficient billing.
2024 ICD-10-CM Code Changes
There are several new codes, revisions to existing codes, and deletions in 2024’s ICD-10-CM updates. These changes aim to improve the specificity of diagnoses and address new or emerging health conditions.
There are approximately 395 new codes introduced by CMS and NCHS for the upcoming year, 25 existing codes have been revised, and 22 codes have been deleted. In addition to advances in our understanding of complex diseases, new codes reflect the need to report medical conditions more specifically.
Key areas of focus include:
- Mental and Behavioral Health: Mental health codes have expanded significantly as recognition of the importance of mental health conditions in overall healthcare has grown. These changes include updated codes for mood and substance use disorders.
- Neurological Disorders: A number of neurological conditions are included in the updates, including dementia and Parkinson’s disease. These conditions are becoming more prevalent among the aging population, resulting in new codes.
- Respiratory Conditions: As a result of the ongoing impact of COVID-19 and other respiratory infections, additional codes have been introduced in order to capture specific types of respiratory conditions and complications.
- Infectious Diseases: This category is updated based on emerging diseases and conditions, such as viruses and bacteria with public health implications.
- Post-COVID Conditions: In the 2024 updates, new codes have been added for long COVID and post-acute sequelae of SARS-CoV-2 (PASC), enabling providers to document and track the long-term effects of the virus.
Key Changes by Medical Specialty
Consider how the changes to ICD-10-CM in 2024 impact different medical specialties in order to better understand their impact.
1. Mental Health and Substance Use Disorders
In this year’s update, mental health and behavioral health codes were a key focus, reflecting the growing prevalence of mental and behavioral health issues and substance use disorders.
- Schizoaffective disorders and schizophrenia codes have been expanded.
- There are now new codes for substance-induced mood disorders, which differentiate them from primary mood disorders.
- Cannabis-related disorders are now categorized under new codes, taking into account the changing legal landscape and the increased use of cannabis for medical and recreational purposes.
2. Neurology
The ICD-10-CM has expanded codes for neurological diagnoses, particularly in older adults, as neurological conditions become more prevalent:
- Codes for Parkinson’s disease with dyskinesia and Parkinson’s disease with dystonia have been added to reflect the growing need for detailed reporting of Parkinson’s complications.
- Codes for dementia have been expanded to distinguish between mild and moderate forms, as well as specific behavioral disturbances related to the condition.
3. Cardiology
Updates to cardiology include a number of new codes related to hypertension and heart failure. Here are some of the new codes:
- A hypertensive heart disease associated with heart failure can now be further differentiated according to the type of heart failure.
- Providers can now capture specific heart attack sequelae by using these new codes for post-myocardial infarction syndrome.
4. Respiratory
Following the COVID-19 pandemic, respiratory health remains a focal point of the 2024 ICD-10-CM updates. New codes for respiratory conditions include:
- COVID-19-related acute respiratory distress syndrome (ARDS) and specific COVID-19 complications, including post-COVID respiratory conditions.
- Codes for chronic respiratory failure, enabling more specific documentation of long-term respiratory problems.
5. Infectious Diseases
The introduction of new codes to track emerging illnesses has brought significant attention to infectious diseases. These changes include:
- Providers can now accurately document ongoing symptoms related to COVID-19 with the new codes for long COVID (post-acute sequelae of SARS-CoV-2).
- Sepsis and septic shock codes have been expanded to reflect advances in understanding these life-threatening conditions.
6. Pediatrics
Congenital and developmental conditions are also addressed in the updates, with new codes added to make documentation easier:
- Coding for congenital malformations with more detailed descriptions, facilitating treatment and long-term care planning.
2024 ICD-10-CM Code: Preparing for the changes
Healthcare providers, coders, and billers should be prepared for a smooth transition as a result of the wide scope of updates for 2024. Here are some essential steps to take.
1. Training and Education
Training is crucial to understanding and implementing the new and revised codes. Medical coders and billing professionals should participate in continuing education programs to stay current with the updates. Training workshops, webinars, and coding seminars can assist staff with handling the new codes.
2. System Updates
The new codes require updating electronic health records (EHRs) and billing systems. Make sure all updates are applied before the new codes go into effect by coordinating with your software vendors. Failure to do so can cause claim denials and disruptions in reimbursements.
3. Review Documentation
Documentation is the foundation of correct coding. Providers should review their documentation practices to ensure that they capture the level of specificity required by the new ICD-10-CM codes. Details about the severity and complications of the conditions, as well as any underlying causes, need to be included.
4. Audit and Compliance
Audits should be conducted by healthcare organizations to ensure the new codes are being applied correctly. Internal audits can help identify areas for additional training and documentation improvement. To avoid penalties from payers or regulatory bodies, it is also crucial that ICD-10-CM guidelines are followed.
5. Outsourcing Coding Services
A healthcare provider may find it beneficial to outsource their medical coding services to specialized companies in order to ensure accuracy and compliance while reducing the administrative burden on their own staff.
This year’s 2024 ICD-10-CM Code changes reflect advances in medical knowledge and improve the specificity of diagnoses. Healthcare providers and coding professionals must take proactive steps to prepare for hundreds of new codes and numerous revisions. Healthcare organizations can ensure accurate coding, proper reimbursement, and compliance with regulatory requirements by staying informed, updating systems, and providing thorough training
Staying up-to-date on coding updates will be essential for success in the healthcare industry as it continues to evolve. Adapting to ongoing changes in the regulatory landscape is not an easy task for healthcare providers, but with the right preparation, these changes can be implemented smoothly and efficiently. The ICD-10-CM updates are just one example.