New ICD-10-CM/PCS Codes Warrant Attention


Here is an important checklist to help you prepare for new codes effective now.

On Oct. 1, the new 2022 fiscal year (FY) ICD-10-CM/PCS codes became effective. The new CM code set includes 159 new codes, 20 revised codes, and 18 deleted codes. The new ICD-10-PCS code set include 191 new codes, 62 revised titles, and 107 deleted codes. Most of the new procedure codes are in the Medical/Surgical section, followed by New Technology.

To prepare for the new fiscal year, there is a checklist of tasks to complete:

Review and educate on the new diagnosis and procedure codes. There are many webinars that review the code changes. It is recommended that you and your coding staff listen, or review a code update.

Identify and educate on New Technology items. There are 38-39 substances or devices that are newly active for the fiscal year. Review the list with pharmacy, central stores, or the OR, and then compare with the list of items used by your facility. Identify the documentation that would trigger a coder to confirm use and assign a procedure code for the New Technology items.

Review changes to the MS-DRG. You may want to work with finance to understand how the changes will impact your bottom line.

Update your facility-specific coding guidelines to incorporate the FY 2022 changes. Maintain a copy of your previous facility coding guidelines that may be used for any retrospective audits.

Review and update query templates for the fiscal year. Review query response statistics and determine which templates may need to be updated to increase physician response.

This is also a good time to determine baselines:

Calculate your complication and comborbidity (CC) and major CC (MCC) capture rate as of the end of September 2021. I like reviewing this information on a quarterly basis to monitor the effectiveness of clinical documentation improvement (CDI) and coding staffs. If you need assistance in this calculation, there is an American Health Information Management Association (AHIMA) Practice Brief on the subject.

Determine the accuracy rate overall, and for each of your coders. If you haven’t completed internal quality reviews, you may want to have an external audit. Coding reviews are a great method of providing feedback to the coders and determining if additional education is warranted.

October would also be a good time to begin the discussion on social determinants of health (SDoH). Determine what areas of SDoH for which your organization has a data need. You may need to collaborate with contracting, as some payor contracts may include SDoH requirements. It is important that every organization realize that coders can capture this data.

The Talk Ten Tuesdays Listener’s Survey from Sept. 28 revealed that most organizations have reviewed the new ICD-10-CM/PCS codes and have done some other tasks to prepare for the fiscal year. It is imperative that the New Technology Add-On Payment (NTAP) items be identified and shared with coding staffs so that each organization will receive additional monies. This payment is based on the ICD-10-PCS codes that identify the NTAP items. These items are listed in the FY 2022 Inpatient Prospective Payment System (IPPS) Final Rule or available for review by listening to the ICD University webcast on the FY 2022 IPPS.

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