The fiscal year 2024 ICD-10-CM codes have recently become active, and they will have an impact on your reimbursement. Earlier this year, CMS announced the incorporation of 395 fresh diagnosis codes, removal of 25 codes from the diagnosis set, and modification of 13 codes— all of which became effective on October 1.
A substantial portion of these code alterations relate to the reporting of specific diseases, accidents, injuries, and social determinants of health (SDOH). This update in the 2024 diagnosis codes arrives at a time when hospitals and health systems are putting forth heightened efforts to address their patients’ social needs and the broader SDOH in the communities they serve.
Regarding updates in SDOH, there are now 30 new diagnosis codes for factors influencing health status and contact with health services. Additionally, there are a range of new guidelines for reporting these codes. For instance, there’s a novel code for documenting an encounter for HIV pre-exposure prophylaxis. A ‘code also’ note directs coders to report risk factors for HIV, when applicable.
An extensive ‘code also’ revision for ‘other specified problems related to upbringing’ stipulates that codes for the following diagnoses should also be reported when applicable:
- Absence of a family member
- Disappearance and death of a family member
- Disruption of family due to separation and divorce
- Other specified problems related to primary support group
- Other stressful life events affecting family and household
Comprehensive data pertaining to patients’ social needs is crucial for hospitals’ endeavors to enhance the health of both their patients and communities. One way to gather data on the social needs of patient populations is through accurate documentation and keeping revenue cycle personnel informed about code adjustments. This will aid in identifying non-medical factors that might influence a patient’s health status more effectively.
The remaining new diagnosis codes are distributed throughout the code set, with numerous codes pertaining to osteoporosis with fractures, retinopathy, and muscle entrapment in the eye, as well as diseases of the nervous system—including Parkinson’s disease and epilepsy.
Out of the 395 new codes, 123 of them are housed in the chapter of the ICD-10-CM manual dedicated to external causes of morbidity, specifically targeting accidents and injuries.